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eaae or qjw trom untgnea vor use on elite 12 Itch Writer. <br />l HAZARDOUS I. Generator ID Number <br />WASTE MANIFEST CAU 9 9 3 6 4 6 0 9 2 <br />6 11 f; sF 7t) ". GMC <br />k" ). AO10l-thILt't t:lh''CsLE. <br />C*&n....,,4 ,, cw% 2C9 951 % <br />{l�.. SE.RVtOE <br />Form Number iroved, OMB No. 2060• <br />2 Page 1 of 3. Emergency Response Phone aOast � ors � J, tf�ov. JJ K <br />1 18W) 42+9300 <br />CAU(i1.t27 7U <br />%t Lta 1i E f t:4t7`'t i2Y YSiEtv1 itVt CAR 0 0 0 1 7 5 4? 7 <br />6. Desigr►ated Fac+Tity Name and Site Address U.S. EPA ID Number <br />IVMA YFIS LLO <br />i 3t231HS1 <br />"tJ► <br />F Phone: t ,aF42B A T �) 0 (y 1i ? 4 <br />ga 9b. U.S. DOT Description (MOkKI ng Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit 13. Waste Codes <br />HM and Packing Group (d any)) No. Type Quantity WLIVoI. <br />14OWKIRA HA AIROUS W/t,;1 C , WJJU ( UILY SODU, PAPER fIn Evs) <br />UM P <br />Li~t"i�l:(IC7 ir;LANifI ; f:Hk�tvil ftEt: 1.-El{it)-424-k7�C}0 WCC& TE�M!NRt.' GEl`.�.� G•'a °' Nt�C)f'iLt` ifi 9t3:% : �fi2�i'�':itdf�:'3FAAttC3�'f> <br />tALY WA.1E". PArt" MLI U13 Af't�hOrrstAYE t'Ft2SC7iVAi. PFt(17tG1)VE E�UIt"fe�LiY1 <br />15, GENERATOR'S10FFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are dassifiW, packaged, <br />marked and labetedlplacarded, 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 certify that the contents of this consignment conform to d* terms of the attached EPAAdmoWedgment of Consent. <br />I certify that the waste minimization statement Identified in 40 CFR 26227(a) (If i am a large quantity generator) orb) (if I am a Fall quantity generator) is We. wl <br />Rerofs Printed/T Name QjU <br />""`"„ � ! <br />❑ Import to U.S. U Export from <br />U.S. Port of entrylexit: <br />Date leaving <br />❑Type ❑Residue <br />or Operator. Certification of receipt of hazardous materials covered by the <br />3-05) Previous editions are <br />4. <br />GENERATOR'S iNIT1AL COPY <br />