Laserfiche WebLink
0 <br />txlaaw print u Noe. (Form designed forum on site 02 -ouch) tnewrder.) <br />0 <br />III ill IIII III I Ill IIIIIII Form Approved OMB No. MO.0039 <br />EPAForm8700-22(Rev.3-05) PrrriasedilionsmobsolWs. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />UNIFORM HAZARDOUS <br />1 Gere IDA4nher <br />��©�I+���J�©7� <br />2. Page l d <br />J. Emergerwy Respunsa Phone <br />4. Manifest Tracking Number <br />1 <br />WASTE MANIFEST <br />877-818-0087 <br />000511944VES <br />SCe shame ��K Gennab(s3aeADbess(dtliRaentFNn maiingeddrass) <br />7 <br />�Ad <br />S� <br />Gene"ds Phowum <br />8 mmspals, lCampmy U.S. EPA 10 Number <br />VEOUAES I'ECHNICALSOLAI'IIONS,1-1_C. NJD080631369 <br />7. Tmnspaler 2 COmpmY Nm U.S. EPAID Numb" <br />S. Designated F y Name and SRO Address U.S. EPA Number <br />VEOUA ES TECH CAL SOLO n ON 5, LLC <br />5738 W. JEFFERSON ST <br />PHOENI7(, AZ R5043 AZ0000337360 <br />Faaphone: 000-380-M <br />ga <br />%4S. DOT DesFnplon (iduding Proper Sh'ppi g Name, Hamm CUM, ID Nimdar, <br />10. Conwriam <br />11 Tow <br />IT Ud1 <br />13. VhsaCotlw <br />Na <br />Type <br />HM <br />and Packing CSouP(demQ) <br />cuangy <br />WtNd <br />1 Rq PolycMvrtnated Dlphenyts, avNtl, 9, UN3432. Ppl! <br />K <br />7401 <br />uWigo2 <br />T <br />2 <br />3. <br />4. <br />14. Specie aM <br />Vivo f G 3� QSot,�6 <br />DATE OUT OF SEFiv10E r'� <br />j ( <br />ER s rAcea pvntrachirl by VESTS DOCai,�g7L4sOe:D <br />1S, GENERATOR'S/OFFEROR'SCERTIFICATION: I hncby decors that the contents of Ws andgsrrntare fully and socuratey described aboveby the pepper shipping eaaigand "e clevlfied, padupW, <br />wwWand aoebdplecandA and are n al"Ads In props, r 19. for rmmpola.m&, beOicsi Imarnslnia and national mmbn/d faguUdaa. N Mow shipment and I son be Primey <br />Exporter, I redly met the contents of %a consgrinerd wmam to the terms, of the "Inched EPAAtlnoWedgMm d Concent. <br />I ow* Oat Oa waste mWrrizadon sMkme t &nff*d In 0 CFR 282.27(a) (O I am a large W ygerorato) a Ib 0I area MAIN 4m ygerualm) Is Ina. <br />Gere\ml�MsIOFArofsPMledlfyp(ed�bl0rne Sfp m Mon Da/ Yar <br />iA <br />78.InbrreliwW Shignems <br />❑ ;Pon a U.S. Fipad hon U -S. Pan darayledt: <br />hettporter sigalum (br expa s ow: cele leevep U.S.: <br />17. TrenVonerArxnaWedgrnnd Rwaptd Mals,cb <br />re 1 PrnkNTypod . Signs Monb Day Yen <br />F2 40 <br />zQ <br />4 <br />ponrr2Pre Name Signa" Year <br />f <br />♦ <br />18.0'ecrepency <br />Via. Discrepancy M.I.n Spam ❑ cossaity ❑Type ❑Paddue ❑Panel RgeNon ❑FWIReledion <br />blandest Reference Ihmb w: <br />180. AIaem"p FaUity for Genanab4 U.S.EPAIDNumber <br />J <br />V <br />Faunys Plane: <br />1 c. at(Mor ee Facilly(aGerwremr) MCNb Ory year <br />Z4 <br />N19. <br />Hazardous Waste Repel Manageoant Method Cod"f1h, codes fcr la;"dous wmbe Yearssw% deposal, am Mcf?df systems) <br />c <br />1. <br />20, Dwgraled Fauly0*mr of Operator. Cansficajon of mcegr of ha a dons malerals corered by Oe MarwhIg except as Wmd In Ikm I8a <br />{I.I'AmIdIttInd <br />Name Sigwa Momh Day Yea <br />EPAForm8700-22(Rev.3-05) PrrriasedilionsmobsolWs. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />