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Place print or tm. (1 - oro desiqned for use on elite (12-oilch)typewnter.) <br />Form Approved. OMB No. 2050-0039 <br />UNIFORM HAZARDOUS <br />1 Generator ID Numbw <br />� P.3(iA <br />3 EffX*Oefq Ft <br />Manliest TruMM l6mobw <br />G B F <br />WASTE MANIFEST <br />5. Gerierav's Name am Ma" Address Generators Site Address (4 different than nW" address) <br />L <br />7 .) <br />ewmawis, <br />6. Trisneporter I Company NarrimeE <br />U S EPA ID NumberNumber7, <br />HPCIVEL, <br />Tran� 2 Compaq Name U.S. EPA 0 NLimoer <br />Designated Facifity Nam and Site Address APR t 3 2615 U 5 EK 10 Number <br />ENVIRONMENTAL <br />Facility's Phone: I T7,1" r.r7ol n-rq W–N rr <br />go <br />9b, U.S. DOT De on (owkift Proper Stippling Name. Hazard Class. Olklumber. <br />10 Containers <br />I I Total <br />12 Ure <br />13, Wage Codes <br />NO <br />HM <br />aind Psdo% G" (Y -y)) <br />Guanory <br />wtjvol <br />1 <br />4DIL Y WATFRI <br />2- <br />3, <br />iie <br />4.Will <br />�8 <br />MOVON MKktbns and AddWnal intotmabori <br />EMEERGMiCY CC)NTACT - SMVE' fOUSER <br />16. C+NERAMR'SPOFFEIROR'SCERTInCArON: I hereby declare that the contents of this consignment we k* and accurattily described aoove by the proper #ipping lame. and ais classified, packaged <br />marked and tabelodplacaidea, arid we in all mspects in proper condibm for transport amoirding to applicable oilernawal and flation6i gowromental regul0ifiarts N exporl shipment awl I am the Primary <br />Exporter I certify that the ronlents of this pnsgnment conform to the ierms of the artached EPA Acknowledgment of Gonsent <br />I c:ef* thal the waste minunizatior, statement 4enfferlm 40 CFR 262.271 a) jo I am a 4rqe quantr,V generator) or (b)'(41 SM a wral W&VP RjWRIOF) is <br />CiHxaratw's/NerWs IMeNTyped N_arr* f SkMahaa ay Year <br />Z/ <br />16 lrriemaw�a; Shipments <br />Export Yam U.S. Pon of entwelft <br />-T—sp— n-- (for exports o*: Dine twang U.S.: -7- <br />17 Trainsporler AcknioMadgment of Receipt of hlawi* <br />Transporter I PdrdecifTyped NarneSignature Morm rear <br />c <br />Tiansporta 2 ypod Name Signature Mordh D" Year <br />I& Discrepancy <br />I& Discrepancy indication Spaice, <br />Q...'y Type j Residue ❑ Parhal Rwbon Ful Rei", <br />Kwfesf Reference Number <br />18b. Aftrko Fadky for Generator) U S. EPA ID Number <br />Fai>ws Phone, <br />18c Signature of Altemale Facility (or Generator) <br />kloftl. Day Year <br />19. Hazardous Waste Report kkwwp nrit Method Codes ji.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />13 <br />2 <br />14. <br />20. Designated Faukgyf)wnetorOpeTaWiCerbfimtionofreceipt oitkwarrlou, rrown" covered by the manifest except as noted to Hem M;, <br />Printed7yped Nam Asqlall- Mono C" Year <br />EPA Form 8700-22 (Rev. 3-05) Previous edftxm are obs*b. <br />mmwm) FAcury To CIENERATOR <br />