Laserfiche WebLink
?311E�51q IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�III <br /> �L bK bH 1 F+IF d a.10:::..r-��. <br /> 008 61937gKS <br /> Please print or type o rt.a- OMB No 2050.0039 <br /> UNIFORM HAZARDOUS 1 Genelatd ID Number 2 t of E F a Manifest Tracking Nu rher <br /> LHU'jt1lb;Js410 PY - ' °-j7r 0 08561937 SKS <br /> WASTE MANIFEST <br /> 5 Generator's Name and Marling Address Genemws Site Address(if different than maim,aCa e55j <br /> Modesto irrigation Uistrict Modesto lrrigaLion Uiscract <br /> kU box 411 yey WoualanU Hve <br /> lylUUtti I U LH j5 o��—Id1610b <br /> Generator's Phone, a�&bN�y� INUl3tb I LH <br /> 6 b,V tTYlAt, .1 e`.t'Y,jItl'ib 1NL US EPA ID Number I Ahid046061dwD <br /> 7 Transporter 2 Company Name US EPA ID Number <br /> LLtHN HHHbUKb LNV SVL 1NL. t*,HUYJS`Jsct. <br /> e Des gwted FSOMY Name and Site Address LLLkNhtkHbUK`a UI- bU 1 1 UNW l LLUW US EPA ID Number <br /> dnOW LUKtKN KUHU <br /> bU I 1 UNW 1 LLUW , LH y.itl0b <br /> bb 1—f tit'—bt10i0 L HU'jbNb!:n r r <br /> Favlrty's Phone <br /> ga 4b U S DOT Description(including Proper Shipping Name,Hazard Class,ID Number, to.Containers 11 Total 12.Unit H 13.Waste Codes M and Packing Group(if any)) r <br /> No. Typo Quantity WINd. <br /> 1,NUN—NLKH HHLHItUUU5 II is SIIL 11I UM N ct i <br /> Ce lUtbllib, NtIHULtLK4 HYUHUI:H1,113I 2 LA Lk 10 <br /> a <br /> w <br /> Z 2 rk7fVINV; NUN—KLHk HHLHKUUU.1j WI I t,UJI <br /> l a l <br /> c9 L-il1U111b, (U1LY WHItH), 11101ia.. <br /> NUN KLIiH HHLHKUUUS WHS i t SUII <br /> i i't I KULtUM U1L HNO U1 K I ), #*e+j#A, <br /> a-L <br /> 1 <br /> o Stxc aI Hanahng Instructions and Additional Information 1 yU;bL I'FUS IV 116 <br /> 9. 11obb IgsS <br /> �4H tpltKbtNLY*8#A kt-4bb-11b10—LHISK/ IFl—Lontr,act retained by generator, conters agency authorit <br /> on initial transporter to alla or substitute additional transporters on generator' s benalt. <br /> 15 GENERATOR'StOFFEROR'S CERTIFICATION: I hereby declare that the contents of this oonsgnment are fully and accurately described above by the proper shipping name,and are dassr%d.packaged, <br /> marked and labeled%placarded.and are in all respects ri proper cortditidn for transport according to applicable internabonal and national govemmental regulations If export shi t and I am the <br /> � Primary <br /> Exporer I certify that the contents of this consignment conform to the terns of the attached EPA Acknowledgment of Consent <br /> en r +rat the waste minimization statement dentif+ed in 40 CFR 26227(a)(if I am a large quantity generator)or ib)(d I am a small quantity generator)is true <br /> Generator-Ofrerces Pented:Typed Name Signature Month Day Year <br /> Q <br /> l L� <br /> J 16 InternationalShipments <br /> 1- ❑Import to U.S ❑Expos from U S Port of entry <br /> Z Transporter signature(for exports only) Date leaving U.5 <br /> 0: 17 Transposer AduvwledgmentofReceot '','_,-;,s <br /> w <br /> H Tranc;,vtar 1 PrnfPdTy�a1 Nam. e.,,,. <br /> Day Year <br /> Z .,,Si,her i Pnc• 7 per 7 Signature Month Day Yea, <br /> l LZ <br /> t8 Discrepa , <br /> D;screpancy Indication Space _ <br /> j ❑Type ❑Residue P,nii,,l n If n <br /> Manifest Reference Number, <br /> 16b Alternate Facility(or Generator) US EPA ID Number <br /> J <br /> U <br /> LL Facivy's Phone <br /> w t fic Signature of Aaemate Faol ty(or Generator) <br /> Month <br /> Q <br /> Z <br /> H19 Hazardous waste Report Management Method Codes(,e.,codes br hazardous*ante treabrient.disposal.and recydmg systems) <br /> ,L 1 -- <br /> 20 Des q1 ❑.rhty qwrvef erllficat'oj of receipt of h ar ous materials covered by the manifes ce as noted In Rem <br /> neSign e aDay <br /> �� t2 (� ���p�{{ <br /> E�1�FP11 , q. 7I�1y11b�t e yc! �1�`f72Jl.�ci: J/ rb4t314/ lcbyl Ili DESIGNATED FACILITY EPA'S a MANIFES SYSTEM <br /> r r ctc <br />