Laserfiche WebLink
��.� �� villi <br /> Please i>-'or:rPe.(Form Cesignec for use on eqb(12 P,tc l'yDe-ter.) <br /> UNIFORM I(AZARTIM " xrly C ar Os r>. E�warry ge�pyy R.rw 1 mardw`ratkv%huniw <br /> WAM MAMFM CAL000018659 2 (800)326-1221 <br /> / DAWN .ESS riiEA6'rtLRY, <br /> 3333 BEVERLY ROAD 2180 E. MARIPOSA RD. <br /> HOFFMAN ESTATES IL 60179 STOCKTON CA 95205 <br /> 1209)948 -8205 GENT 117'82 <br /> Genersltor'a PMrw <br /> t aiT TRANSPORT, LLC U.S-F I <br /> !� NDO58484114 <br /> 7.Transporter:: o v"Name U.S.EPA 1-1 Numb- <br /> ' TAL SERVICES, LLC S EPA o Norms <br /> 5122 EAST STORET ROAD AZD081705402 <br /> COOLIDGE, AZ 85228 <br /> (320)723-4167 <br /> F .Plartr <br /> I ti ab I;S 10'omoft''mamma Pvw Shorne van.bear im r0% e.r o rta.r., o .v <br /> l „u aha P►Wg Grow to any;IPe <br /> t3.Waste Codes <br /> X , RG WASTE AEROSOLS,2.1 ,L)N1950, (D001 D039) , 33f 00 DO <br /> ERG#1 X16 >D D03 --- <br /> L X2 W <br /> W RO WASTE FLAMMABLE I-I9UIDS N.O.S. ,3, DOO J <br /> UN199i,PGII, (PAINT) , (D001) ,ERt;0128 <br /> � 3 <br /> Xa R9 WASTE DI <br /> LPI 30 PGI1 (HYDROGEN PEROX16EN.O.S. <br /> 114 D ()0 SODIUM ' <br /> HYPO(1iORITt),(D001),ERG#140 to <br /> °�:w 'NOW _ 3.W12 G450303 LOR 4.149 8439579 LDR <br /> [1113805] <br /> 15. 1%W CERTFICATK)lk I hereby dedms that the co tent et UMt consignment are fully and accurately described above try the proper sh piling name,and aro day Aed,Packaged, <br /> m-ired-M IatNlebrpkordW,and are In all respects In proper condition for transport according b appic"ittamadonel and rational governmental regulations-N export shipment and I am the Primary <br /> Expel-,1 aeA{(y tlrt 9re corder 4 d INa cwrelgranent conh rm Oo the lerrre of the attached EPA Acknowleci rrr-A of Cament <br /> I ooI t*the wmb mw*r&Wm sla*mt idm6W in 40 CFR 26227(a)(d I am a prge Quw" (bl(f I am a small(iAr generator)is true. <br /> ntpon ro S ❑Export kom U S ::^M M erty:em <br /> '• •,L^amw 41^ow4dtjr0!I aeras[(d Maws* <br /> 01 <br /> Ira aporbr. ypedti :a ala Liar low <br /> 1 <br /> ,8.Discrepancy (� <br /> ,Be.Disci p Indication Space ❑ Y ❑Type J Residue ❑Pertld Rnuj.. ❑Full Rejection <br /> Manifest Reference Number <br /> I 8b.Aksnab Facility(or Generator) U.S.EPA ID Number <br /> J <br /> U <br /> LLQ J <br /> FaciNys Phone: <br /> <W 18c.Sigrtatse dAAernate Facility(or Generator) Month Day Year <br /> Z <br /> N19.Hamrdoue West Report Mana9ixtant Method Codes(i e.,mdet ter hazar0oua waste treatment,dtaposat,and racydiN systems) <br /> LU 1 H141 2 H141T H141 7 <br /> H141 <br /> 20.Dasig eked F Owner or Operator Certification of receipt of hazardous materials covered by the manifest except as noted in Nem 18a <br /> Ll Prkt4xYfyped Name Day Year <br /> ", I <br /> EPA Form 8700-22(Rev.3.05) PreviDuieditiong are obsolete. DESIGNATED FACILITY TO DESTINWON STATE(IF REQUIRED) <br />