Laserfiche WebLink
� a <br /> Please PrInt Dr type (Form de-signed for use on eine{`2 ptr i Fcrm Approved OMB No.2950-OU <br /> 1.Grerato!to Numbe+ Z Page 1 cr `s E;bergs ry Respsnsa F ra c 4. to tack€ r <br /> UNIT M HAZARGUS � L E <br /> WA TE MANIFEST <br /> 771177 etor'S Name n d Mai;;n,AddrusS Ge efa4c3!'S S9te Ar.°r1reSS(ef ..refit t!7ar!RAaI9Ir9 i;ddrt- 1 <br /> P!Ime t1.5-Eft ID N9_+mom€ <br /> Trani er" 3r<� ry F,1 3Tw <br /> T>anporter 2 Com-pary Name U.S EPR iD Numter <br /> & s nated Fay irty Mama and Site Address U-s:,E?4!D Numt�c-r <br /> 2Cii t Phone: <br /> 7 3 ascr ion E^c udiny Prop,5^ Nar.1e,Hazard Class.IO Num^ ,e° :.'JE e s 11. Jr: 12. Waste Cade <br /> cry GrOu rf a y)1 rap TVD@ Quarrilty se..;21e Ix . <br /> 1-7 <br /> I ; 3 <br /> ............................ <br /> 1 <br /> 14 3Ip <br /> a,hrr I;ger G5 ardy�,.n - <br /> f 5 < <br /> NERATOR•Ss'OPFERCIR'S CERTIFICATION: +gip declare �.r°s consisv'xnrsrr,are tui y and a...,u�afe:r descr d ak�+e.�;ens w sh,;;pE q rsarre,end are class fW packaged. <br /> ar r:adaled+p(a d ,a rd a u a°'+ es c+s i ger.Rnd+, n°c- a.c'd a='d ng tc adplscaala ante raa.i:mai an•;n... .a;Bove rr�" :a re;u a vis.If expari sE lament and t am ire Primary <br /> ccrie•,I certifv th-tune car+ers cf th s cbnsi.gnnem cordo".�c the Perm:of Site arched EPA Af*',owv edgment Uf 0�-em <br /> e f nkat a us+sie mint.€ on seta rani des t� 1 n gfia CFR x&a 7fa$, I a. a urge�u3r.,t.g_ne atc.„r . a s ;aa 1fsPy generator)is pue.. <br /> en8r rrs-' <-r&Z Printed7W Name _ ag�3tur0 . dud , Dav .Ear <br /> __j!.,rpm Ec!_'.3 <br /> ortar svalwrt;sV expults Only,. <br /> T s 9e Rck edgrnttaf R pz o`Afsterals <br /> 77775 rd9RC <br /> Ca e <br /> t� <br /> `Z Tra er 2 Pmledffvped Namersty;2' MW Day Year <br /> 4 <br /> rY <br /> Sa screpa cy'qCFt kn Spate y Pad a:ReieCt',e^ F€k Ratan <br /> ",?a,-,tes1 F2eEe��s.ce`tarttter, <br /> i8h.Aerna>e F ddity s.3r saratart U,5-EPA 0 Ntjmter <br /> U <br /> Q <br /> `^ rdG10. 5 <br /> ph-01'.e. - <br /> Ca <br /> LU 18c ralu=e c'R"e eat PaCIH#y for Ge^a of tr PdCa th Day ez <br /> z <br /> ":3 H -^rde:s N ascs Repan Ptana.er,¢-€1+e7xx:Cry� .e names ia€ttaz:•ard�as waste#+ea�en3.rtisar+sal,and recyu€rxq syrrs <br /> r 3 4,. <br /> L712 <br /> Z�.z� s:�at�Gac+lit;f?a^aer of O�t•at3c Cerbfu,etlor.ar r�ipt et t�aza.kacd r^a°e a,.,3'a.:� :�a rr 3 est 8xcs ...: r .,.. <br /> ;fy ed Name Day Ysa <br /> Priv? <br /> EPA Fp , 7 22 jRpy.3-,U,) Previous editions are obsolete, t ENER,TOR$iN T iAL"t <br />