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Pleasep&t or tpa, Form ved,OMB No.2050 U039 <br /> UNIFORM HAZAit00U3 1,Gerwfator In Humber 2,Paps 1 of 3.Erneryeney Reapaus Phanw an n Nu <br /> WASTEMANIFE8T 0 01 l 4 l�.9 VES <br /> 5.Genereios's Hams and f4leiNrq Address Y1,XCMA%LVAN Oersaa r a Site Address Of dlfisrerit tlwn mal@sp addrssa) <br /> w mc IROMM 8AM <br /> SWX=Wcerwrata$i�iane�37'17117 <br /> I ti.Larlwpaier y Name <br /> U. .EPAIR Nun r <br /> 1 <br /> 7.TmmpwW 2 Company Name N <br /> U.0 EPAtDNumber <br /> UNUM HM UANWM 3C D 0 4 S O S It 4 9 t <br /> B.t)eelpnated Faolky Name and 8b Pidrow o U.S F) D PMlnlbar <br /> +Y+.TVE K M'�.AL1 71 , <br /> 1'791 W,i'rt�Tli'1�T <br /> F s A :LIK CA 917a C A D O O 19 3 0 2 9 0 <br /> 9s. 9b.U.S.DOT beseelpl on(I ng Proper Sl*oq Nam,Retard�,ID Numbest, 16.� 1i.TOW 12,Um}{- and Padrksp Group(N any}) No. Type On" SNt Not, 13,4Vasth Codes <br /> X UKIM 1. aff <br /> PA r 1113Q1+tiAMiIILS+iQdlEJ�dC} 1oS DU01 391 <br /> I . D M 1 7 9 1! imps 1W <br /> X 2 =9lk1,WA$'I'$nAMO [B irpQl; UGt37 LA19 <br /> 1 �3►7x <br /> 1 C F 77 P, Y= . UL* 1112 <br /> X s »KWANJ7I .A#tI11AU "All 1t'A04 OtTb1 13t�9l4 <br /> ��.i[1RJILlA�,9,,11 <br /> 1 D 7 247 1` » Mo au <br /> X a. t WA=LB1HY1i.=i"&iMnw 3►11 D001 <br /> I C F 20 P 301 <br /> 14,FpM KwiSV lfthwAm and I Sst7ArA1�011i14rVlIAiN + Kahw`o�e INGIMaerM�pw�d ol Rf�O�'IlilQCt129'01;71r31A 1l �>1>1 129 , W w5we A A0 <br /> 15. 0EHERAT0R'$f P""'$CERTlFMTtOM:I hereby declare theh the Caedanta of 1Ma oassgmrrenl are tuiy asst arxuraraly daauxhed above by th@ proper ahippkp Hama,eN are cfaaslAed padreped, <br /> marked and fehetedlplecarded,and ere h all reapede in proper cnndglarl hr tranaisosi s ocardkg tP apptkxabte hdemafbnd end risilanal povenynarrta! utaltorss,7 export aNpmenl acrd Ism the Pr9rwry <br /> Exporter,I w*that 0%oomienta of this oonsbmwnl oaitorm to she fauna of the aWad EPAAdmv#Wpmwr,t or c**ea <br /> I cantly that the waste minimbatlors atelamersE Identified Nr 9D CFR 252.27(a}(Y I em a{alga quenTly perwraEor)a(b)[El am a small querrtity peoeralora Is true. <br /> Gawralor'slOhws PNn%Vyped Nemo Helots Day Year <br /> YULMAaALVAN =A= <br /> ` <br /> ts.ntematlona s Ipmenta ❑Import to U,3, ❑ <br /> dt <br /> Transporter sfpnatare((or exports only): from U.3, Porto!�a <br /> W 17,Twspo&A*wwk*msnt of Reostpt of MHbf la � p U.3.: <br /> Transparier 1 P�dn�ltwryiypod Nano + <br /> ��MR�I.ffi �r aw <br /> Y � Y <br /> A I 7 <br /> Tsanaporler2Pdnhed/Typed arses <br /> /•.. , "B Month rW Year <br /> is.DL-aaperxy <br /> iso.Ellsaepawy lndkatfon Space ❑ (;z..t ty ❑1Ypa ❑Rasidea LJ Pertld ReJerdsas ❑Full Ra)edlan <br /> 1st.A16aarwtw Fadlityr(a Generator) Mwatteal Reksarsoe Number. <br /> U.S.gFin Number <br /> v I <br /> Facatys Prone: . <br /> LU nsdse to Fe Vty(or Gwnaraiw) Day Year <br /> 71 1 <br /> 19.Hazardous Waste Report Management Mathed Codes(ts.,codea for harxadous waste frestment,dbpsposal,and recoN syafwnw) <br /> 20.tleslprseted F ny Ovrtrsr or Operator.Cer9Acatlon of rgoalpt twzardous materials covered barb mwft#&aNAapd6d h Rom i <br /> ams W <br /> imu— <br /> EPAForTn87&22(Ray.f2-M PreNous oditions obsoleEe. DESIGNA CILI IEPA's 0-MANIFEST SYSTEM <br />