Laserfiche WebLink
Form designed for use on efita 12-pitch writer. EoDn Approved.OMB No.2tI50 Q9S9 <br /> UNIFORM HAMMUS WASTE MANIFEST 121.Gerwator ID Number 22 Pegs 23,tJtudf"t 1roaldng Numbor <br /> (Conttnuallon Sheet) GAR 0 0 0 Z 6 6 Z 4 7 of 3 001792398VES <br /> 24.Generator's Name MD EX OR.OUND <br /> 26,Transporter Company Now U.S,-PAID Number <br /> t 26.Transporter Company Name U. EPA I©Number <br /> 27a, 27b,U.S.DOT Desaiptlon(Induding Proper ftft Name,Hazard Clear,tD Number, 28.Coalatrrsre <br /> HM and Paddng Group('d any)) 29.TMaf 30.Uric 91.Waste Codes <br /> No, Type Qt an* MNoI. <br /> I W5.115. 1 <br /> , HII SATTLCI HyppAMIXTURES HM 39GFVALBL CHLORINE, D80I <br /> I Dy 62 A <br /> + 181 <br /> PESTICIDE,LIQUID,TOXICk 331 <br /> I DF 68 P <br /> 7.U93-216-41. as(HDWI1tTIC8f , YOUR��ACD <br /> D002 <br /> pppg saw <br /> I DF 97 P 741 <br /> '- I3 LU . �l !a �I I� R $ D002 <br /> 1 DF 46 F 121 <br /> 0.UN3260 CORROSIVTi SOLID ACIDIC.INORGANIC <br /> M.S..61YI)R.00HLORICACh5,9, 11 t81 <br /> I DF 13 P <br /> 1Qtwjg ff OUS WASTE LIQUID,(011, <br /> 331 <br /> I DF 63 F <br /> 32.Special Handling Inetruebm and AdMirial fntonnas ,0 W 7! 0 I{ A ��� �q p3 <br /> � b�� � C 6A�1P1�98�PA� 9)ERG: <br /> 33.T nt of I of Meledals <br /> Prtnledrl)pedName 3 nahxe <br /> A1adh Day Year <br /> 34.Ttanprt, AWavledgment of Reset tofMatedals <br /> Frintedrlyped Name Sipnalure Month Day Year <br /> 35.Olscrepancy <br /> 36.H to Report Management Me I .,codes for hazardous waste tree and retyding systems) <br /> S. <br /> �i <br /> t7 10. <br /> EPA Form tM042A(Rev.3-06) Previous adMonsare ohadefe. DESIGNATED FACIt,l yTO DESTINATION STATE(IF REOUIRED) <br />