Laserfiche WebLink
The Guide to Potentially Hazardous Material Management <br /> Reviewing a Manifest Before Signing <br /> Revision de un Manifieato <br /> Verifythis is yourStore Address Verify this is your <br /> &yourStoreContactlnfo Store EPA IDd Manifest # <br /> n..R l,r a,.�aftm <br /> ".. 11Mar ,,. <br /> xv. .a ,MV 6 1 3 2 a l 1 1 a , essl si%aaz 006024841 JAK <br /> ...u.+..m^ & Mar 0748 <br /> A �m0.0yi,WYadod 810 East St <br /> �(at91 Pu-ttte r'ea,W etsot <br /> a vraxe sol relm Emergency y <br /> Response <br /> MNSOo 0 1 0 0 8 3 a <br /> Transporter Phone <br /> Name&EPAID (make certain i <br /> n <br /> ce Rirga Del uamiv ^ <br /> dt <br /> li <br /> isse <br /> (make certain &W Nay Li one ) <br /> there is an entry) ,, I871ao nIs A GA 30019 AA 0000128 B ie <br /> WULWT�t.maw.»n�.o�...e.. ,. Disposal <br /> AM Facility <br /> 411— N w `uNlssgwn%A.mm.,lnrmmrey z.,,w,Ewenm &EPAID <br /> sa <br /> An"X"or"RQ" E `0x,993yaearwimemnµft,nas leVatrol.Mari (make certain <br /> indicates there is x wn.ri oneislisted) <br /> DOT Hazardous 'VN17M y VS wmmaa wds.„n.•. taoma, <br /> Material X .caro-Niroee%Pcu.ERc.,e< <br /> tquwvwu.con pepweled <br /> Make <br /> Proper isles "'°°`�' certain EPA <br /> Shipping3510 or State <br /> Description raa.a.�aa,®.r.�r...a..^a,.em..y..e..a.N.r..•w.�,..^a..aw.a Waste <br /> Areab^s:, ^...o-m..,..a,....�^^^.-. Codes are <br /> (must be ^n ^• tl ^^�: aNn^..a... o-a�^ ..mw..rn.. <br /> listed <br /> filled in) >w L <br /> C '• Cw..e�a Oawr N.a»a. <br /> ' ~app Store <br /> a^^ •+ r Representative <br /> Name & <br /> Transporter t ',o-°,^°'�',r„•,a, 0� Cm. 717 11...•w.. 13 w. Signature <br /> Name& (to be <br /> Signature �i�� a.a,aa... once <br /> (Required prior o,.... once reviewed manifest <br /> is reviewed <br /> to departure <br /> ggand information <br /> fromyaurstore) r�Nr confirmed) <br /> ( 7 <br /> Disposal Facility Name&Signature Legend: Itemsto verify <br /> (included on final copy received <br /> approximately 30 days after service) Signature required <br /> 11 ©2019 Sally Beaty Holdings,Inc. <br />