Laserfiche WebLink
Fax Server 8/6/2015 4 :01 : 05 PM PAGE 6/046 Fa t: rLIVE�_:l: <br /> AUG 0 G 2015 <br /> Pfease.Pont ortip.(Form desigtfed for use on elile(12-Pft) ,) <br /> U=ME HAZARDOUS 1'Gvra.. . NUS' 2Pa9e1 of 3.EMIIIA Re3pm3e P!rona 4.Nm Nest7racking Nonem - 2d5dUC3B <br /> WASTE MANIFEST �� ��� <br /> SGenemm'sNweand Nai4nBAdtFau. .l'- ^.4 .. d ;"•-'�Rl�.i�F, . <br /> CalempyaBOe (doffiawMtlmnmrplgadmaN) <br /> �:a�li3ti57_''..ii'�e. ��Irz(vpUSTIJfiS:!'+� <br /> PP C3iV L.0 <br /> AJi�'r'iii:sS t.�i)n i'JFEF.FCn.1aIRT:Cs vii. <br /> Gen~sPhane:'•nr. •w ir•,.• STi?"'T�iv'. ,..5-,rg "e'_,•.,,, <br /> fi.TmrOpamr 1 CarpmryNemo .(.4h r`_71`..`.1 9]:'ub <br /> ' U.S EPA m Nmbr <br /> e;"x/11:� ••*t.^:^'1$'f.i S^.d;rT'C'a!R <br /> I.Tmnyormr 2 Cally Name! <br /> F✓t L/J V f(� US.EPAIDNUMAW <br /> N VY1�a:TqL St�.Ir GES CIJTOODI<1 <br /> fl De&q,emd FatlNy Name antl SNaAdbeeA y2'`) <br /> VOLIA"cS TE:C;•I,i:�Lanf. i!OT1S us.EPAIDNumfiv <br /> ?,...C.' <br /> Si ai HEKSLi`r STF3ET . <br /> 9a 9hpaddNQuT(p�l(mdNl9n9Peepel$N'pPl�NemRNamdpm,mNDrt�L 10.Conla9,ers ... <br /> FOA u4 Peddlp Grtup(Nan») 1t Toy it Unit <br /> Mum. Y 1A1MekCdds <br /> 1 No. Type Cwn9ry WNtl, <br /> p <br /> L .,!slh- ,.n _{I <br /> 2 <br /> i <br /> 4. <br /> u <br /> � f i <br /> i <br /> i <br /> i <br /> 14.8pedWHandlmjfnsnucdws.d PdditlmallMormeGpn' i <br /> EkBerriiei<eDDaccevA:VEST: � I)W:!0466AcyrC.�Ri3A;tinMA) <br /> 15. GENEdSIGFFERDR'S LER'f07CATIDN:I)wabydeEw 9ml Nrconfm6ol08 m,dgnmmtwmFyardamimmytlasodaed above NY me WoPermlpPin9rwu4 atl waas45etl,pamaged, <br /> merFm andFaandfaboleapmmrtted,end em In aA respantvin DmpaamdiStl fatranspalacmNep ro appNaahle 4Aeme6or,tlandnetibr,d <br /> bponar,ION*diet themntemi of mmmrm'9nm,t cmfbnbme lmauofenatmcYed EPAAdopvAedpnentolConsaM W'rmana,mfm9alam,N.l(emmsA!prem aMlam ma Phnary <br /> ImafymN tleuatm ntlnio'vamn amtamer0.Mentlfied In I0CFR 262Z1(aJ(dlam adWEPandMWemror) tof(XIamasmaNWecerygenemmr)isbue.- <br /> Gmaala/sIGNn°r°Prnled7ype77d Noma Sgremm <br /> !./li Ctil -i Nab, Mer <br /> _., te.nen'...af Sliprnams .. ii.ex il'1 , D 111 1 ) ? <br /> T omptldrou6 � o�DA�dDb. f>artala9a <br /> ra,3portarsipreWm{lweapals <br /> 17:TmMpd(gAWwaMgmenldR�IptmMelMNs . <br /> TMnspodarl Pontm/F NameSWA- M <br /> ff YM <br /> Y. <br /> 16 Dmmspon y. <br /> 18N.lMwpawymtllnOonspa� ❑Wan6ly LJ T* ❑Residue . <br /> ❑PaNal Refection 13MR1 <br /> 10b.Apanala Fadiy(arGe,mrabrJ Mandem Remrerm Numbs <br /> U.S.EPA ID Humber <br /> U <br /> Q <br /> LL F8PYy3 RYMM: <br /> W 1&signa .o AAemme Fa (m br) <br /> Q Monty Day ym <br /> Z <br /> w79.Hezerdpm Waste Report Ma'ragement Memod Lodes Qe.,codes Mha7allous waste beabrentd$pmptamregdngsy,6 ) . <br /> 3 4 <br /> 29.OaY,p,Yed FaWNyOwnaaCpamtor.C®tl9mdonofNte'pt ofhazardom gmlalak covered by the nurLemauzp(as naedm reRl9e <br /> W �d YPeH Nem¢�-� <br /> (R�'3�) )11eYlANb edlBons are dl�lefe. <br /> DESIGNATED FACILITY TO GENERATOR <br />