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SCPPW <br /> Please pr1M ort pe.(Form des' ned for use on We(12-pitch) pewriter') 7f12f 201$ Form Approved.OMB No.2056-0039 <br /> UNIFORM HAZARDOUS 11.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4. nifest Tracking NurrdW <br /> WASTE MANIFEST CAL 0 0 0 3 5 910 2 (800)4$3-371$ FLE <br /> 3.Generator s Name and Mailing Address Generator's M Address if different than mailing address <br /> DTE SUNklmLLC <br /> 252s w.W SVfflK 2526 w Win stmt <br /> e�enera 71D0 . AT M�fii - 5t�ttat�.C1495203 <br /> B.T Var WINirte U.S.EPA ID Number <br /> T <br /> 7.Transpoder Co any Name U.S.EPA Number <br /> .Designated racifty Namg and Site Address U:S.EPA ID Number <br /> burr Hawiws LLCC <br /> 25 Welt L�Rom; AD 9 8 0.6 7 8 2 7 6; <br /> 6moniii6 ESA moo: <br /> 06 <br /> F s lie: (MI -6200 <br /> ga. 9b.U.S.DDT Destbiption(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12,Unit <br /> HMand Packing Group('dany)) No. Type Quantity 1Nt; <br /> Nol. 13.Waste Codes <br /> ' <br /> 1.UNi7M. VE SLIDE.N.0.3:.UIMENtC.C t 571 <br /> o X S.�Ill.Om't'QMASH] <br /> uu <br /> LU <br /> 3. <br /> 4. <br /> 14.Special Handkng s and Additional Inforrnatton <br /> I-CM 49380: <br /> 15. GEMATOWSIOFFEROWS CERURCATION:t hereby.dedarbttrakthe=Mnts of this consignment are fully and accurately described above by the proper shipping name;and are classified,packaged, <br /> marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If exportshtpmettt&W 14m the Primary <br /> Exporter,I certify that the contents of this oonsownent conform to tlte.terms of the attached EPAAcknowledgment of Consent. <br /> I certify that the waste minimization statement identifled in 40 CFR 262.27(a)IN i am a tatga:quantity generator)or(b)(if I am a small quantity generator)is tura. <br /> era s nn yped Name Signature MoW Day. r <br /> .1 16,Irrtemagorrat ' <br /> fi ❑import to U.S. ❑Export from U.S. PAof en exit: <br /> Transporter signature foF Date leavin U.S.: <br /> aC 17.Transpwterftnowledg(nent of Receipt of Materials <br /> T t PrinWyped. a Signalprej <br /> O r. <br /> rarisportar 2 Printe a SignafUre Y,at <br /> 18.Discrepancy <br /> 18s.Discrepancy Indicaflo.0Ance ❑ Guehtity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest Reference Number: <br /> 18b,Alternate Facility(or Generator) U.S.EPA ID Number <br /> *a - <br /> Faclfl s.Ph e: <br /> 18c.Signature of Alternate Faragty(or Month Day .Year <br /> 19.Hazardous Waste Report Management Method Codes(Le.,codes for hazardous waste beat wt,disposal,and recycling systems) <br /> 4. <br /> H132 <br /> 20.Designated Facltify Omer or Operator:motion of receipt of hazardous materials coveFad by the mantfest except as noted in Item 1 <br /> s do yped Name Signature More 1) Year <br /> 1 <br /> EPA Form 00 22 Rev.3.05) Previous edt&ons affobsded, ED FACILITY TO DESTINATION STATE(IF REQUIRED) <br /> clean Hadws the VPWiW P00b fK and WX 41*0 t tk Wage the mgr is W pp . <br />