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The Guide to Potentially Hazardous Material Management <br />Reviewing a Manifest Before Signing <br />Revision de un Ma tifiesto <br />Verifythis is yourStore Address <br />&your Store Contact Info <br />• <br />Transporter <br />Name&EPAID <br />(make certain <br />there is an entry) <br />• <br />An "X" or "RQ" <br />indicates there is <br />DOT Hazardous <br />Material <br />41111— <br />Proper Proper <br />Shipping <br />Description <br />Area <br />(must be <br />filled in) <br />Transporter <br />Name & <br />Signature <br />(Required prior <br />to departure <br />fromyourstore) <br />Verify this is your <br />F Store EPA IDd <br />M..wie, ao". r".. <br />,,. <br />Mini b <br />,MV <br />.w,,..N.�.,.m.... <br />4 1 3 2 5 47 1 <br />1 <br />W)= <br />) SRESZ 006024841 JJK <br />r.uwnw., &enga 0'!465 rwrnr..omrl <br />Agr1m0.DyI,WY4.dod 910 East 5[ <br />� (4191 24 4114 8 PabfieM, M4 m201 <br />SIB s Wash Sol'mIm IMN 50 o o 100024 <br />Hone Recydng B Dbpavl assort <br />9520 Nay aro <br />sisi18 <br />r,s. (9IeI a?A-1t15bevs <br />AA 0000128 B ie <br />AMW <br />-uN1950,MWb ABmWr, IrMmmSbl f. 1, M, sai <br />sea <br />m <br />` 11X1593. w.eefwimamlp.+ft.nac (imarl <br />x <br />PGII.UA 128 <br />UN17M W VS Wnort Iwds.no.., l+�ftene <br />X <br />cdumv1�b19.PGII.ERG154 <br />NhbeIDMus, Nan pyJWele/a <br />spa <br />1.51 <br />3,5192% <br />3,510 <br />4 51M 51M <br />mia.,mtiwh®r msaVnuW,�nNw.*,�hmmanMwCweW rt urnpaµ <br />wTMmw6't ueuWra4aa <br />L <br />C <br />° Cr...aa OBrr raw. <br />S4 <br />mvM <br />r <br />r,..r+..r ❑e..„ Cm. 'J... i�wxy,�n i�new. <br />o.I.....al•rrn c.e.crr <br />Mass_ <br />i 7 <br />Disposal Facility Name & Signature <br />(included on final copy received <br />approximately 30 days after service) <br />11 ©2019 Sally Beaty Holdings, Inc. <br />Manifest # <br />Emergency <br />Response <br />Phone <br />(make certain <br />oneislisted) <br />Disposal <br />Facility <br />&EPAID <br />(make certain <br />oneislisted) <br />Make <br />certain EPA <br />or State <br />Waste <br />Codes are <br />listed <br />Store <br />Hepresentative <br />Name & <br />Signature <br />(to be signed <br />once manifest <br />is reviewed <br />and information <br />confirmed) <br />Legend: Itemsto verify <br />r Signature required <br />