Laserfiche WebLink
Plnsae ndntatuoe. !Form deai0ned for use elite 2-oilrh)tvoewti[er,) FOi1D Approved, I No, 2050A0S9 <br />=PA FMm R7O!} P7 1, 8 M FM ed bone pre obi 10, <br />UNIFpRMNA7AR000S 1.DmerelorjElls��-O,&TRWK <br />2, Pagela <br />9. ElnergeN.y R84Ponee Fnme <br />a. wral"t Tfaaklm NYmaer <br />WASTE MANIFEST CA07. <br />000-7404449 <br />G g F <br />5.Gefsralor3NamearAMa fVAdd�eb3 ria tDNRM �dm�Tlddemattmm ingaad�) <br />3.PLA2N 1Q740'M 7THaes, <br />{qa cn:952aZ241Trarwputer <br />1 fmgaq Nemo U.S.f3AIDNumbef-%,AAG94�11>1Ttl9ttS:-1NG <br />., :,,..�.., ..... .,.,..'N ,..CAMOOM64 IT, <br />7. arwpabr2Canpaly riwne U.s.PAID NumW <br />1. Der9WO FaOTfy Namead SuaApoleas x� <br />.1 uu��. �.GR�aW.�A•'+LLGt „:W,, r ' a ' � > ., �: < u�z q iso�'"� „ y.1 <br />�N. <br />.t...d'T �Yulti�T�uT�1FTIJSP.�i? •1 C. .� .y�A. .?'�J`,f ..�•r Y:. ., n. . T+—'�i_�ttvi.I, t <br />GeGRDovA,�^i 45742�:- <br />Fad! Picea° <br />p& <br />96• U.S.DOT D88*don (nduaQ Proper <br />Name, H=rd awA ID Number, <br />10. Gmwrh <br />11. TOMS <br />12. WR <br />1s Codhs <br />No, <br />TYPe <br />NM <br />end Pukip GMw W"D <br />t7.* <br />MAU <br />1: <br />.,..v.r::_s,.,:.R.::•.�,,........��u <br />MYO[nv.-,.;, <br />w <br />ir:�-. <br />•223' 3 <br />AB8flR8ENe01t8' <br />x : <br />(p <br />0-4+ <br />V <br />, <br />4 <br />ATROOkATUROT 'RE•C <br />W,4 <br />SEEERG#iTl : .. <br />. • <br />16. GENUWGK'&OFFI]W6 CERTIFM.ATION:I <br />derlhm tMlthecmyna hFNk mrigvnant as klyerd aaaemy deamlad above 6y Ne popersfdfgnp Pame,aM aie paIXaged, <br />maMed aid WI;"p*AWod,®d are in al respe <br />s in pmpermrA&n for hanspAl rdlm b applicable IrA=B§oaW and nafonal gbr lal mguW*M aeryMsMprwtv,e l am Ih Pdnary <br />Eaporbr l mNy Net Ne amtents ofVz <br />t=ksrmwmeta ornaauaace4(FAAdpMv"msntorCOWt <br />I wty Natdp wash Mirktatlm MIM" <br />In4OCFR26W(a)(dlamelagegw*eme6 quaNby geremlaj taws. ' <br />" <br />e 4) , z o <br />❑hnpMbU.B. <br />❑Eepm hanlUS,. Patamdyleudc <br />1 wkimm (for expose ortw <br />Dam laaNng U.S': <br />17. Tranapo twAdavwIo#r;w Q(RecoOt of Mdgiak <br />M <br />SC <br />N <br />� <br />ren9podN2 yped <br />&gnaLea tdW6 <br />K <br />. <br />rm*.o, <br />16.Dismpancy <br />160 FNtGeparWy lndlryan SPaoe ❑ Wendy <br />❑Type ❑NesWaa ❑P'u F4.0m Ell <br />Madkel Rskrmw Munber. <br />166.Auar.ew FadSy(at oq <br />U.S. EPA ID WMbef <br />LL <br />Fsdb's Phaa: <br />w <br />160 Sgnaae aApernBb etlly (aCvwraku) <br />�. <br />Month Day em. <br />18.HuaNwa VJack mepwlMavrganoM hlotlrod Codes.a, <br />mdeaMhszMdau; imsk toahren<dspoad.em regxying sy*mts) <br />1 <br />I� I <br />z <br />3. <br />a. <br />20, <br />DWOWM FOPOW(TMmrnr APnmfnr faAfraYon C( <br />Q(hmvdoucM Warmed by (ho rumba[ ox9opt w n4o in Wn 16a ... - <br />a M -t y aar <br />=PA FMm R7O!} P7 1, 8 M FM ed bone pre obi 10, <br />