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b6L_ sn txhlN# ir6rr/i/ ilflllil�lililfllill Ili <br /> 0 C Is igll illi <br /> +lease print of type. orm+Approve 003 An X20504039 <br /> UNIFORM WARD01M Generator ID NunOe L14Lbt4IC�11 bUO 2.Page f N �.E C��s�nagPha� 008�61385 SKSWASTE MANIF EST 4 <br /> 5.C,enewces Name AndMaing Address GmeralCrs SiteAddnras(If dllfetentihm ma Eng eddrm) <br /> kica Iran Hnd Metai <br /> 181tj (Navy Ur• <br /> S I LJL S i LIN l:k 'd5L"i b-11 Iii <br /> Gelnee2�r6pa5tPcdAps��ePfMtCren. 'c'43Nam^e�Sc'-llltll <br /> 6.a`tirC 1 Y—Ic kM Yy 1 khiti 11'iL. u 5 rPA ID HumLar f x H lrtri&ti 1�a� <br /> 7 TrweWrler2 Canpany Name V.S.EPA ID Humero+ <br /> LLLMN HNklil:dtlb ENV tivu I NU. PliliIIPSJ i�7'c,t4 <br /> &pesignafed Facility Name aM SHeAdd cSs ULL:HN HkkbUHS 5WN J UhL U.&EPA ID Number <br /> 10el ftk"fth64 F{iJR <br /> bHN JUhi- r UH UaIS� <br /> 416F1--441-09HE1� i:FL11V]9�J4'J4r�119 <br /> realm phone: <br /> 9a %.tl S OPT Dmoption Including Proper Shipping Name,Harrod Coss,ID Number, 10.Con'u, s 11 ToI4 i2 UnN <br /> HN and PaC Jng Group lilanyl) 13.Waste Cotes <br /> ntr type quanrdy Yll.fVo1. <br /> "'"W3dUN HGOR HHLHNIAJU6 WHb f L bULIBEi, UM <br /> o LF}ikbbx"BhNtb UUN1kM1Nl 1L9 Wt IH LIIL2i 010 <br /> w <br /> mi 2. <br /> W <br /> i7 <br /> 3. <br /> a. <br /> ta.$"I Handim Inmictlons and AffWwral Information I SI):bJ H Wit/fS l WL.St�4/1 <br /> e4H retained by generator carrrers agency auCnoriv <br /> an lnitial transporter to add or supstxture aoc11t10nad tra ers an enaratnr's behalf. <br /> 15. OENERATO,$AOFFEROR'$CERTIFICATION:I h2mby6eenre lhothe Contents dlhi5car+nam grelulfy and Adi,rafefy d ibrl+Love the properahipping naw,and are cles3[fl d.9aclaged, <br /> nhaked and labeledlpfacarded.and are in aN respects n proper mndllion for eramport awarding to appioaWe in7polagdnetarW n Tonal gave+ ntal raguuuons.Ilaxpnrt arhshmenl and 1911 els PriR1ary <br /> EppcWer,I canify that Che contents ct the ccneignmem crevorm m dre Urms dlhe awed EPAAcknccvledgnxaf of Canoe nl. <br /> rmnirythat Ithe waste minunizafion statement idenNed in 40 OFR 262.27(a)IiiI am a targe p73ntdy gNneratoo a Ib)ttl am a aH yc x )o true. <br /> GYaxdafola20derofs Pin yp6d neM1rre Mon% DRY Yen <br /> Iatefnavanal bripunIs <br /> F Irrgptip U S. ❑uponiroa.ld.& Porl of antAde <br /> RE Trensporrer dgnafure(W axporls only)- Date leaving u.S.: <br /> d' 17.ifenaponerAdwwledgmenl Of Receipl at Metal* <br /> Ira r 1 PrniedR Bme Synappa NCrdh NY dnaY Y <br /> 1/1 <br /> x 'I p 12 nrpflrlyped Sgruhlure � Da Near <br /> A l:Z <br /> 19.dacrepancyv 01 <br /> 18a.Disuepancy Icalirxi Spatz ❑Ouantiry ❑TM ❑Residue bon ❑FuN Rejtxlicri <br /> MRndest Ft¢ferBnfx fAanber� <br /> 1Bb.ANemete Faulay{or Generator} US.EPA ID Number <br /> J_ <br /> V <br /> vas. Facbryh Phone: <br /> 18C.Signature WAltemale Facility(or cncvarnr) H00h Day Year <br /> 4 <br /> 2 <br /> Ia.Hazardovs Wade Reporl Management efelhod Cades(i.e..codes for hazardous caste trearnent,dspoael,end mcyc ng sysrmo) <br /> Ph41 <br /> 20.DBSlgnatfA Facility Omler of operator:CY ftfidw CI reoW Cf hazardous materials covered by fNe manifest except as tied in Hem lea <br /> n6 Sxfrianrre <br /> JG � Momh Day Year <br /> IN <br /> >� AIiMSniB �6YLa1 I� �y <br /> Ef k Wlidm 7 t a�e ous editions are obsolete. DES IGNATE0 FACILITY TO EPA's e-!+MANIFEST SYSTEM <br />