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P..ke Amc, <br /> No.90-500009(Evemet 9.30-961 See instructions on bock of page 6. <br /> riceForm ete�UmOf for..on.�112 "vwmn. O-Ponvnem Of To.. SubstancesAL soc'me—te.C.Ijfo,,. <br /> UNIFORM HAZARDOUS Generators US EPA ION.. Mentfifta O.MjW`l4.. 2. P." I Inforetmtion in the heated creme <br /> WASTE MANIFEST ci If I i Jis nal rpsrimd by Fd"I low. <br /> 3. nartal's N9g.me and Mair Addfl"4 of <br /> is A. State MwJfest D";m,*W <br /> labor <br /> 'S S252t; <br /> tt c/ i� <br /> C4 <br /> �n A. C.a , <br /> ' w" Ph. 9Y 5 14,�, <br /> 00 T f: <br /> C,rrpovy Ntsme <br /> 6. US EPA 10 Number Q Stale T HO.. <br /> t/- C e SEW '71VC- - -Z Trwaparteet Photer. <br /> 7. Transports 2 Company C6181()K)jq t' <br /> 0 <br /> U G. US EPA ID N.mberr Stale Tronsporlen's ID <br /> t I <br /> vC F. tronsparsees <br /> 9. Dnionated I.." o, ,,a Addriew 10. US EP'A 10 hl.�� <br /> G. Stale leadws 10 <br /> j <br /> � t <br /> to le l .per <br /> Fadktf%.VbQo9 <br /> OCT i1lnc:4lton.(mcludbg Pioper Shipping Nome,Hazard <br /> 1.and ID Number) 12-,Container, 13. Total I <br /> NO. T Quart %"(Nvol <br /> o E <br /> ac N b. <br /> E <br /> R <br /> A EPA <br /> go Tr. 3iaS.eL� <br /> c. <br /> 0 <br /> R <br /> CPAtOlO.' "V- <br /> Z <br /> O <br /> h6' <br /> < <br /> Z <br /> 2 15. Spee -1 <br /> iesl Handling I-00ii. <br /> aml and Adda .1_,--mmr <br /> < wov fr",in :,; <br /> Z <br /> 16. GENERATOR'S CERTIFICATION: I hererb,declare that the camel of this cOowgnrmmn are f.11y.nd <br /> packed,marked,and labeled, -clulmnlY cl-oclib-d-6.by p,.pn,�hippioq name and are—cl-,.f..d <br /> U and One in all r"pecm in proper condition far trom,an,by highway according to applicable international and afiorcl <br /> government regulations. <br /> If I orn . large q <br /> uantitY Qmemmor. I certify that I have 0 Program in ploo:to reduce the volume and toxicity of -note generated to the degree I have determined m be <br /> economically Practicable and that I have selected the practicable method Of ftenmened,$Immpe,or dismcd currently available to me which minimi,,o,the present and funne <br /> threat to human health and the nrvinmenemt;OR, 4 1 am.mail W.hlY generator, I how made a good faith effort to minimice my wavle 9nneration and select*.he best <br /> IY varte mono 'rearet evelhod that 6 available to erm and that I can afford <br /> 0 Prints Typed Na <br /> i,.- Month Dy Y. <br /> U <br /> Z 17. rarv; de,I Ackrvo-01,7 IS 9 1` <br /> I Printed/Typed -----------P pp <br /> -!ignan, Month Day <br /> Year <br /> 0 18. Tram, dm2Actino-----,--- <br /> ei t of Materiels <br /> O 1, Printed/Typed No.. <br /> I Month Day Year <br /> 19. Diwrepancy kedicafion Spme <br /> F <br /> A <br /> Z C <br /> I <br /> L <br /> 1 20. Peak Cmor or oto CerXfkation of nXerPt 01 hazardous 1 11 1111 1 covered b2 this manifest sa except noted i 9 <br /> "I Printed/Typed No. Item I <br /> Y ID -' 4 m Month O.Y Y., <br /> DO NOT WRITE BELOW THIS LINE. <br /> DT5C 9022A (1/95) <br /> EPA 870D-22 5- <br />