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Smolt Of fipe1QrNp.-1INr0nfrlmka1 holnfaa w�Y'�E��Y <br /> I.Appra.;d GME No.4030-003r ff"iP r]OW) See Instructions an bad page 6. 13"no,e of To.s Suboanre,Cart. <br /> Fksy F-W m ype. form d gyr�br ve an.Sle�I rypewrder. �"w Sanamrmo.Cahlome <br /> UNIFORM HAZARDOUS 1. Gergro of s US EPA ID No. Manifest Doc."ne W. 7 Pape 1 Informalion in the sh.ded areas <br /> WAST! MANIFEST is mf..,ulnad by Federal law. <br /> of <br /> 3. Generators Name and Mailing Address ISOL Martha ',lSdeb4 !ti.y" <br /> ALBERT VETTER <br /> WE^ Pe 0. Box 146, Gustavus, Alaska 99826 R S"Gonfrawl1D <br /> A C Generator,phone 190 <br /> 97-2357m <br /> d <br /> S. Tronsparb 1 Company Name 6. US EPA ID NumberC. §Myj TrofNp4j11Frk IIS <br /> to <br /> 1^ 1& 1� 1- 1�1- 141117121515 D r Prep. 661-6642 <br /> 7. Transporter Z Company Nome 8. US EPA ID Nomber E.'.SN/G7{9e!!pa�,J/r IP <br /> U <br /> n` I I I I l F. TFImspel es <br /> .Z 9. Detignotod FociBry Nome and Site Address 10. US EPA ID Number Sta1F ,I 'r'-- <br /> np PRC PATTERSON, INC. <br /> 13331 N. Hwy 33 " P.dCipc,Patterson, GA 96363 IrIA101 Ini�111& 1111i�ln <br /> Ef,bn, <br /> u. <br /> i 11. US DOT Oescnption(iKWding Proper n <br /> Shipping Nome.Na,ord Clavi.and ID Number) IT C"imir, 13. Tool id. Unm <br /> Z No. T Ouam' Wt/Vol I. Woos Mambo <br /> 3 HON-RCRA HAZAPDOUS WASTE LIQUID602 <br /> EWATER 8 OIL �" <br /> N b. <br /> E yme <br /> < It FPA/CAher <br /> A <br /> T c. <br /> R4 G Fir' <br /> ¢ a A/Odes. <br /> W <br /> W d. .9�... <br /> U <br /> W EPA/WAer. <br /> N <br /> Z J. A*WonW Deuripfk a for Malanols Word Above <br /> N. Handlkp Codec lir Wgaes Ud.d Ab.. <br /> ° TANK BOTTOM WASTE b. <br /> KINSATE zv <br /> Q Mc <br /> 0 15. Special Handling lastrudim,and Additional Information _-- - -- <br /> a APPROPRIATE PROTECTIVE CLOTHING site: 1035 S. Aurora St. <br /> W "EMERGENCY CONTACT: (209) 667-6692" Stockton, CA 95206 <br /> SEE E.R.G. PAGE 31 <br /> I& GEN@ATOR'S CERTIFICATION; I hereby declare that the cora-n"of this comignmery a1,fully and accur0bly described ab.by proper shipping name and are<la"itied. <br /> Packed,marked.and labeled,and are in oil nespec"in proper condition for tmnspoo by highway according l9 applicable irm maliond and naKonol gov.m%om regulmian,. <br /> U <br /> III ore o Ione ..amity peneraor, 1 unify shot 1 ham o Program in place w reduce the volume red toeicity of waste gene,oa d to the degree 1 hem dewnranod m be <br /> KOnomi,.*, Practkable and 16.1 1 ham a Wlvd the p.1k.1ble method of treatment, ,taage,Or disporol c.reral, availabk w me whish mimmian me present and lutura <br /> HN1rem 19 human heahh and the an.tror .; OR, if I am o small qumtity generotor, I hove made a good faith effort to minimi-- my wap.generoeon and soled the Into <br /> was*mmo .mart method thot is.v.A ble be me and the,I can afford. <br /> pint cl/Typed Nome,Richard Thorpe agent for Si9^�r• /� Momh DaY. . oar <br /> Alhart f. c <br /> 2 17. Tr iter I Acknowl d emem of Raui 1 of Makripl, <br /> W N PrinMd/Typed Nom. i 9r1a Si lure _� Momh Day Year <br /> 1 o I8. T r 4 Ac ..rant of Reesipt of Ma rlals <br /> W 7 Pnnted/Typed NomeSi n91a <br /> a. F <br /> 0 e ManM Day fear <br /> 0 <br /> W 19. meuq awy ksdirateme Spore <br /> F <br /> V A <br /> Z C <br /> L <br /> 1 411. Facility Own.r or 1010,Certilkation of racet 1 of ha,ardous materials owed 6y this marrifta Ke t as na,,d n Rem 19! <br /> YPrimed/Typed Name .� gootare '� / Mom11 DW year <br /> NOT,* <br /> OT RITE O HI N ` <br /> UTSC sa]RA (9/r31 <br /> EPA 6100-71 Green. TRANSMSITFa RFTAfMC <br />