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1�a 5o print or .,(Dorm designed for use on eilto(12-pitch)typewd(m) fort A Proved.I.OW No.2050.0039 <br /> UNIFOR HA MOW 1e.Generator iD Number 2.Page 1 of 3.Elnerganoy Response Phone. S. {a�nn fust Tracking t�umbo�r^y � ��� <br /> WASTiw MANifm9 t >► 1 1 371✓a7d7 01 7 14��� JJ K <br /> 5 6mriatocaNameandMollingAddress Gmaratar'sSite AddressptdiEforontthan Mailing ardress) <br /> AIMUC AVIATION. Vi 4-6S <br /> mWimemisT <br /> VOCKTON,GA SM <br /> G000rator's Pbone", <br /> 6 Transparler 1 Company Nam:i U.&,EPA I Nunabar <br /> RAM09 SWOWWAL SERVICES INC, CA00440}3M <br /> 7;l'ami;of tat 2 Company Nasre U.S.SPA+p Nualber <br /> a.Dosignawd Pncimy Nama and 30 Address PACIFIC RESOURCE RECOVERY U.S.EPA ID Nurnbor <br /> 3160 CAS P IS NW, <br /> CA( 3M5�� <br /> LOS Amaems,CA%m <br /> raci""s Phone.; dna}^71+15 <br /> ja $b:U.S.DOT Deectiption(including Proper Shipping Alamo.Hazard Claso,IU Number. to,Conlatnors 11,Total 12,Unit 11 Waste codas <br /> 1 jM ..and Packing Croup Qf any)) No. Typoy <br /> Quandt Wt.fVoi. <br /> X t UN1203,WASTE GASOLINE,3,Pad DIVI G $31 1=1 10013 <br /> kc <br /> CQ <br /> 2, NAi9 , MBUST113L>=LIQUID, NQJ, COMB,PGIII (JET FUER) i3M ^� G 331 s � <br /> t;a .� <br /> 3. <br /> A, # <br /> 1d8kt 3Ut>KA6tr@ i� y. 1Zpww <br /> ci 4)` <br /> A % <br /> Z clx,., , CCRTIFICA11ON:I herufiy dectnra that the contents orthio consignment are fully and accuralaly described above by the propershIpping name,and are classified,packagod, <br /> maned aaxl latded,And are to all mopacts In proper condition for transport aeeolding to applicable intomaiionaland naUonal governmontal regulations,it expolt ohipnaont and 1 am the hrlmary <br /> Exporter I certify that tate contento of this consignment cwrfonn to the terms of the atfacharl EPAAcknowtodgmenl of Consent <br /> I cwQjthat the waste ntinimimilon statement ldoniffied in da CPR 262.27(a)(if]em a large quantdy gen for}or(b)(111 all)a roaall sot tt t tAfs is he, <br /> s iG.Inir matdiel S Import to V75. Export from U.S. f gttPt)t <br /> Transpafer at nalUro for ex its onl). �tyi �= - <br /> C- 17..Transporter.4cknowiadgrtmntoFRacrlptafhtatorials <br /> Trans rrtnr tk. rrra Fr'anth Day War <br /> i � <br /> ramp flat 2 ar'>Id Sane ... Stgnauiro Month,I Day Yoar <br /> �; se..alsorepanay tt--tt <br /> 18a,Discrepancy Indication Space Quantity L J Typo LJ Residue ❑Partial Rojeoli. t _i Full Rejection <br /> ( <br /> Manifest Reference Nurnbor. <br /> lab.Alternate Facility(or Getmator) U S.SPA ID Number <br /> GJ <br /> Faclkrr's nfaona: <br /> nttc.S19041ro ofAllomate P'aciuty for Generator) mitb Day �Yol <br /> 10 Hazordous Waato Repast Management McUmd Codes(I$.,Was for haxordous waste troamrent disposal,and mryclrag syatoms) «a. Mr <br /> 0 1 VC, 1 2 � tJ El <br /> 7.e.,Designated FoMlyownsr or Operator:Cortilloatlon of reWpt of hazardous matedals covered by rhe real nifoot except as noted h item tea <br /> PneladMpbd ams y bignalure t cath ay Year <br /> -ALVA` <br /> ERA ronn�8700-22(Rev.3.06) Previous editions arrf obsolah.� OMMATED FA(,IIdi�"a'TC1 DES41RAVUH STATE OF REQUIRED) <br />