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27416 <br /> 929019 Foran Ap roved.OMB No.2050-0039 <br /> Please pNrR orlype. Form designed brass on able 12-plfch tyPM.itefJ 2 Pagef of B.Emaryency Response Phone 0.MemfactTwcldnO Nuoaer <br /> UNIFORM HAZARDOUS 1'Oe�ramr ID NumSa _ 0 5 5 17 2 2 0 JJ K <br /> WASTE MANIFEST OeneretoyaSlbA(Rnddrew(B dfl 26 than eem9 addraw) <br /> 62 <br /> 6.Gmamta's Nae and N811119 Address HOME DEPOT #HU5576 <br /> HOME DEPOT C(0 3E CONPANY 101 D'AACY PAY%YAY <br /> 1905 ASTON AYMMUE 0100 <br /> Gera -8 U.S.EPA ID NUmber <br /> 6,Transponer l company Name CAL2000164012 <br /> 1st HT71I. MANAG&NEUK OF 1Rl A 'LI( EPyA�ID�Nwnheerr y��p^p y� <br /> 7.T Sparer 2 COM Name u"t K 0000v l�V� .I <br /> '�Y_'/1/LP U.S.EPAIO Number <br /> 8.Designated Facility Name and Sin Address <br /> MUALINGTOM EEYIIONMEMTAL, LLC. %EMT FACILITY <br /> 20245 77TH AVBMUE SOUTH 14AD991281767 <br /> Fa sftna:%ENS 11 5803, 253 312-8030 10,cwtal�a 11.1,0101 12 Unit 17.Wade <br /> e CD <br /> ffiU.S.DOT Damnptlon(IncWdhg Proper Shipping Name,H"t Class,ID NumNo• <br /> ber, Quantity <br /> WWoI. <br /> Jim aril Padkg G"i( nA <br /> O RQ <br /> g 6001 D035 331 <br /> W 2UM1263 YASTE PAINT MELATED MATEEIAL 3 PGII EQ(0001=100( 0od j*j cogo P <br /> ED RQ IF <br /> b.0231r , - <br /> Fr <br /> —48 <br /> '7 SC <br /> D002 122 <br /> Q 4.UH3266 %ASTE COMEOSIYE LIQUID, MASK, INOEGAMIC, 11.03. (SODIUM Cd0 ( 8t4— 0015" P <br /> X HYDAOIIDE, POTASSIUM HYDflO%IDHI 0 PGII 10012=1001 . . y <br /> ` — 14.Spedd Heading NSlnrmans aMAddiionallnfammfian l X .y j�• . <br /> 1 a Parr1261 IRROSCla. (21 H0113-13 - ERU(128{ FLAMNAMLE LOOSEPACM <br /> (dF@d£@3 BP$tfi (4( ROMEBH-04 - E%G(154( AL%ALIME/COBMOSIOE LPE0203ALi: <br /> 16. NE rGR'SIOFisbeledER d deendlareNell mspeds in proper con®Ihn faVenslpalaxadirgga a?Df bre nnemationa�land ra'Ianal 9wammenmll reguleinrns.IfPlexpM Shlp eroand am Ba Primary I. <br /> Expmm,,I cdlifymat#,,madams oftNe mndgnmentmnfum In ma terms of Na enacted EPAAll,*edgmenl of Consent - f <br /> I moth;at the waste mlnlrdxedon smteawt idontleed in 40 CFR 262R7(a)Pf l am a large quantity generator)(a) (6)QfI .tl quanmy genaramA is WtADRm Day Maare. 2a <br /> Gen emlofsl09ato( , _lfyPed Name <br /> cz <br /> t0.ldmnefunal 9yepmdds ❑Fipatfrom LLS. entry/exit: <br /> ❑ImpodmUS Dal suing U.S.: <br /> � T19nspq[lasi9palure(for evppPe only): , <br /> or i7.TansponerAdalowledgentof Receipt OfMaledals Nreaurs Nance Day Year <br /> s Nmpoder I PdnWFyped Name <br /> AREN P P_ SINGN Naha ✓ a 7 6 <br /> o Monm Oq Year <br /> S'gnaWe <br /> Qrenspanaz2 PMledl(ypad Name /Cf/M/�Tl/y - z.0 OQ <br /> � SLT <br /> 18.DkmePam/' ❑Residue ❑pared Repction ❑Fail Rejenlbn <br /> 18,Disuepmmy lMketicn Space ElCywgH ❑Type <br /> Manifest Reference our ad <br /> U.B.EPAID Number <br /> 18b.Alternate Fadlly(a(3meramr) <br /> 7 <br /> u F16%'s Plane: Day Mr <br /> w 18,S11 naeurectAeemam FORY(or Gerema) <br /> a <br /> w19.HazatlaosWaslaRapon MenageeM Niggard Codea11 miles for hezardouswasie Yeatmam,dlsPvsel,and recydmg ryseroi 4 <br /> Q 1 2. <br /> 20.Desgmamd FaceBy Ownero,Opemtor.Ced IMat"aid of heamd"'TNSL,mvaed by the martlesst e"t asraed h limn tee ^Daay Year <br /> 1 Prim y o <br /> EPA Form 0700.22(Rev.3.05)Prevhoe edibnns are obsolete. DESIGNATED FACILITY TD DESTINATION STATE(IF REQUIRED) <br />