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07/10/02 WED 15:36 FAX 805 525 4172 FGL ENVIRONMENTL f�j008
<br /> ., .,.,..k.N.N, N
<br /> Department of Pollution'�Itrol and Ecology
<br /> P.O. Box 8913 Little Rock,Arkansas 72219.8913
<br /> Telephone 501-682.0744 /l
<br /> FUNIF
<br /> i,rm tleedned for use on Beta 12. rCnl'.-awnfarlFdmAPMovee.GASB No,2450-M.9 EXPIRES.9-40.95RMHAZARDOUS 1 lrr+zrsu PA ]la. awnrti ager mwmnnan�n:ne a,raeoBreast-r.STE MANIFEST C a L 9 2 3 4 3 6 7 0 9c0/Pnfs/° 9 tea°"!°a'Pedlralwwl nv A,Stew Mawlo bab,me,Nw�ulrnv_ronnental
<br /> 2500 St-=�-ecoach Road , StecAron, -a, 95215 AR. 906437
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<br /> 309 -rine r;:can Oil Rd
<br /> El coraco , .AR 71730 !.iwq',P-"a
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<br /> iAConianai xnrtnt9r Ni:anLa Lis:ea Abave t.Mrergen�y P.eamnse lnlarrranan;
<br /> Pro E' 1 No . 4a to No.
<br /> 11a)(o8;XS6IX �r4L-I llc )ES �y('� o�(�c,L 24 Hour
<br /> _.1Lh1bB3gby�lk �F6L- lld) Q&9LY, Cfj(IGt4 ______ Frank W. Doerfler, Jr.
<br /> if no alternate TSDF.return to generator (805) 987-0217
<br /> ear _ ro;)er nrotect'_ve ;ear who: handling hazardous natet`_als
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<br /> GENERATOR'S CERTIFICATION: I hereCy dmiare mat Te COnteme c-m:5 Cdnsdgnmerll ave fully ane accurattey desmea am"Oy Omer sntpomg name and an,
<br /> requlaalln5 am An ginsaS Sale eg�Snd are in all r6509ct5 in proper=07wIOr,raMpdn by Ngnway aCcbrdtng to appItcable inlemalwwl and national gommmom
<br /> II I am a large Ouantay generator.I cemly mat I have a O.gram In owe IJ reduce the wh me and toxicity of waste generatetl to the degree I havC delermnled m be
<br /> KOnamma9y pracucebte and that I have SetEdwd me prac.=Ce,mecnca of'treatment,slOn gs,or ditppsy curenlly available w me w ;eh minimizes the present am
<br /> future threat to Puman healm and me,emrenmem;OR.if I am a smab c amory gene,9:gr.I ha"made a good fait enon to mommze my waste ganem loo am Z~to
<br /> beet ,,asfe management method mod"au8eable 10 me aha at I can a'=r•J.
<br /> �•�:rinYbed Ilam! i:aha"
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<br /> Form 8700-22 Rev.9881 Previous edition Is obsolete.
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