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Emil 1111 <br />Generator ID Number 1WKA <br />�• 1/1 WON i <br />7■1. <br />5. Generators Name and Wimp ail -• r *F-_ r . <br />". ; 1. Iri, <br />.. a,. .� . � •. �E./a- :4 MFI'w./w= Plaza <br />_;< -4 t s:l �.. 1^ I:.,,v. _.. ..tA {:, at.: (.. . Plaza <br />�.. . 'rt--.'�-' <br />n � J. F ,�,,, <br />stock <br />T.-Tiansporter I company Name U.S.EPAIDNurnber <br />`.i},r,i <br />:. n1EIRIFOWerdol 501 (1111311% CA000436W <br />U.S. EPA I Number <br />1• r• r ..Name and t-oss Address 1 Number <br />• <br />*91702 <br />Phone: FNi 'F62&33"117 <br />.r <br />and Pa"g Group (deni r <br />� <br />IN In R <br />i <br />�. <br />, <br />f <br />`£►'1 <br />40k". TNT ; :. "_ doss: 1. , !`- 1�"a 1 s. ,,1 <br />Y <br />:- <br />M r z <br />y a <br />+ <br />-- at 1 1 Instructions and Additional Information <br />r.. i 4 s <br />iprmm _ sods.- ^ kV .:: .� Y 2 <br />-7429 .c : z: <br />15, 1 , /hereby"declarecontents of consignment and accurately, r•r above by proper shipping 1 name,ard are classified, packageds <br />marked and labeled1placarded, and re in all respects in proper condi0en for transport according to applicable inlemaknaland nalilonal governmental regulations. If export shipment and I am the Primary <br />' <br />rr, .• - .r , this consignment ,r r r ,..r • Consent <br />, 1quantitygenerator) <br />codifyminimization Identified • r is , generator) <br />,ri to US, ElExporilftom.U.S.'r r : <br />1.: r <br />,r : r1 rr r <br />T <br />WA <br />:I..:r. �/ <br />_ <br />Manifest Reference Number. <br />., <br />Phone: <br />1801 SignatureofNiernalo Facility(of Generator) Month Day yelm <br />10. Hazardous Waste Report Management Melhod Codes _ codes._ hazardousvraste treatment, disposal, and recycling systems) <br />II .., <br />1 <br />PA Fortri 87M22 Previous editions :,obsolete. ,, .,. , .14 <br />