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Please print or tyfee_(Form designed for use on elite (12-pitch) typewnter.) Form Approved. OMB No, 2050-0039 <br /> UNIFORM HAZARDOUS 1 . Generator ID Number 2. Page 1 of 3. Emergency Response Phone 4. manifest Tracking Number <br /> WASTtNAEFEST 4 9 FLE <br /> 5. Generatofs Name and Mailing GA, 0002� <br /> rens Generaor's'Site Address (If differenrlhan mailing address) <br /> SP LTD <br /> 1 ��M'�'V /�wom u11flYfE.h�!1'lfli3�TflC�8fT91ltB.COYYI <br /> Gee atoTs'Phone�'. <br /> 6. Transporters Company Niii - -- U.S. EPA ID Number <br /> Adwrred Clwnlcai Transport Ino./OBA ACTEMI/R0 CAR00007OW <br /> 7. Transporter 2 Company Name U.S. EPA ID Number <br /> 8. Designated Facility Name and Site Address U.S. EPA ID Number <br /> Adiianced Chamrcai Treatment <br /> 6133 Ed& @Ad NE <br /> NM E7107 <br /> Facility'— shone: � <br /> 9a. 9b. U.S. DOT Description (including. Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11 . Total 12, Unit 13. Waste Codes <br /> HM and Packing Group (if any)) <br /> No. Type Quantity Wt.Nol. <br /> Vic 1CR31325, Waste Flammable solfde;, orgawlc, no-s- s <br /> 0001 <br /> X (ACETONE, METHANOL). 4.1 , PGtt �1 ! " 0035 F002 <br /> FD03• F005 352 <br /> z 2. <br /> w - <br /> c� <br /> 4. <br /> 14. Special Handling Instructions and Additional Information <br /> ProJeU Number 161577 DDuirianf 1l: 0193563 <br /> 1) ERCM33; ACT327.20 CrRAit G - , L C q X -5 CTI" <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents 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 export shipment and I am the Primary <br /> Exporter,, I den fy that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. <br /> I codify that the waste minimization statementidentifiedin 40 CFR 262:27(a) (if I am a large quantity generator) or (b) (if I.am a small quantly generator) is true. <br /> Generator's/Offerors Printed/Typed Name Signature Month Day Year <br /> 16, International Shipments / <br /> ❑ Import to U.S. ❑Export from U.S. Port of try/ xil: <br /> z <br /> Transporter signature (for exports onl : Date leaving.US:: <br /> W 17. TmnspoderAcknowledgment of Receipt of Materials <br /> Transporter i PnntedlTyped'Name Signature Month Day Year <br /> a . <br /> Transporter2 PrimedlTyped Name Signature - Month Day Year <br /> F- <br /> 18. Discrepancy ❑ Quantity ❑ Type. ❑ Residue ❑ Partial Rejection <br /> Inc. Discrepancy Indication Space � ❑ Full Rejection <br /> Manifest Reference Number: <br /> F 181b. Alternate Facility (or Generator) U.S. EPA ID Number <br /> U <br /> Q <br /> LL Facili 's Phone: <br /> W 18c. Signature ofAltemate Facility (or Generator) Month Day Year <br /> a <br /> z <br /> y19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> 0 1 . <br /> 20, Designated Facility Owner or Operator: Certification of recelptofhawdous materials covered by the manifest except as notede-Iterri8a <br /> Printed/Typed Name Slgnatu a Montfr --Qay 7 <br /> EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br />