Laserfiche WebLink
W <br />31040 m ProtscMon AserKT <br />Fess Approved OMS No. 7050-0099 (Eq*. 9-30-96) See Instructions on Back of le 6. D.porhaeal d Task Suboercn C".1Smm Paid w type. Farm dssbeod fer u.s w Dns 11TofAh1 r`ir c. <br />DO NOT WRITE BELOW THIS UNE. <br />DTSC SMA (9/96 <br />w3A 8700-221o1L.w; GENERATOR RFI AINS <br />Smramwae. Cdlpda <br />UNIFORM HAZARDOUS <br />1' Gemsalels US E►A (D Ne, Mortified, Document No. <br />7. pope 1 <br />k trent on ti 1by d %deal went <br />WASTE MANIFEST <br />ji' !� '^j 1 i' �/ Y (; _w '1 r ' <br />t <br />is net required by Fadetal law. <br />o <br />3. Oemmlor's Name and MaiGp Address .. �,• r <br />t -+.: rJ A; ; S rL. Gift A, •1 <br />A .. <br />...Wash"rn <br />I r: ys •+feY;1 <br />t#Wftha <br />ID •• <br />N/ <br />/..+tSl"r'1 <br />A. Oemmlorh Plwrr r) fr -r r'li r .. r :c,. w..J i c t.; S <br />Rii <br />S. irsyror40r 1 Company Name 6. US EPA Number <br />C. Sears Tmnsporw's ID <br />J <br />f -ti tr •G LOM <br />ECY "Lir , <br />D. Tteawar': Phos. <br />t <br />7. Trmsperter 4 Cnmporq. Nam 8. US EPA ID NumMr <br />_ <br />E, Sime 1—p.—Iel ID <br />i <br />F. Tromporlgis. Phwe <br />Z <br />QOC <br />P. Dedonakd hdWy Name and Silo Address; 10. US EPA ID Numb. <br />FRG YAVENSOwe <br />0.. $kft FgOlVt 10- <br />'[P.Q. <br />kC! k0 - A D 018131 1 616171 [ 8 <br />13331 N. ftdY . 33 <br />H, r al; <br />Ann — AILAIII <br />Z <br />OT <br />11. US DDw dpdon (idud o, Proper Shipping Naim, Hazard Clam, and ID Number) <br />13. CarMalren <br />13. Tonal <br />1/. 1/nR <br />No. <br />IT <br />Ovm' <br />Wt/Y.1 <br />I. Woos Number <br />C <br />a. <br />. <br />Sole <br />5 <br />YZI <br />Ne -1i RCRA HAZARLOUS VA3TE i14UXD <br />old// <br />N <br />Is. <br />T <br />TEPA/00. <br />t <br />� <br />E <br />R <br />EPA/00w <br />A <br />T <br />stage <br />O <br />tW <br />R <br />EPA101 ar <br />A <br />- <br />W <br />Slab _ <br />V <br />W <br />N <br />EPA/OSwr <br />0 <br />1; Addlousal Deecroars, fro M.Wk4 Uftd Above - - - <br />K. Holdthp Collis far Was" Uded Above j <br />6 <br />Is. <br />WATER & 011a. <br />1 <br />-.. <br />d. <br />Z <br />Q <br />13. SpecialHandling hrd.uAwu acrd AdAlbd Ydarmolton <br />24 fiR. ENFk.GENn CONTACT. PRC it -000-S74-4444 <br />4 UR. tMERGNtiCY 3?EflPOtiS6s MVj!, IEL INC.#J-000-155-3924 <br />APYROPRiATE Y&OTEC:LVE CZ01P1hG u KLSPLRATOR. <br />16. GENERATOE'S CO1Ts1ICATM: I hereby declwe Bret she vas k s of shh cmdgmwns are fully and accurassly described above by proper slopping rams and an classified, <br />packed, mmlud, and labeled, and oro io all resp«% In props cmdfflw for lramporl by highway mwrdbq to applkable Witematiwal and rational q mmm mgulaliws. <br />If 1 am a large quamisy genera", ve <br />enera, I C.* that I haa propre <br />-- F place to duce she wlu-e and baidty m <br />of waste genated b the dee egrI hove debrmird b be <br />mosamkally paclkobk and that I have ssl K d We wmdc.ble mdhod of "ai mrs, sWage, or dkpns-I currmdly aw11able to me which mi i l.es she prmsem and fakers <br />threat to hums heobh and the anviomned; OR, H I am a .11 quantity permrabr, I Iota made a good foilh effort to-ininiee my waste 9mmmsoo and seled 140 bed <br />worse emd method lhm is avdkbis h, me std Mal I can afford. <br />0 <br />PrddRygd P40me <br />Srpnall" <br />.Irgy� rYw <br />Z <br />T <br />17. TWm,I of of Moledds <br />!3( <br />N <br />t;;- r'w <br />%'" - <br />j <br />.A,...1 <br />.,[,,i.�'s .''es�..`•'_'�- <br />r <br />r <br />r Z Acinawlsdawnwil of Recelot of Alen" - <br />T <br />P hftd/Typed am <br />blpafws <br />Moss Dep Meer <br />g� <br />19. Dbwepwa.T krdlcdien Spats <br />3► <br />A <br />Z <br />C <br />— <br />1 <br />L <br />F <br />20. Fader Owed,ac0males, fsNReaMw of reasird of hamrdws mdedab aavmed byMrs madiwl soamot as noted in Rem 19. <br />7P'i'md/Typed <br />I'bi's Stature. <br />Mo.* fby Y. <br />DO NOT WRITE BELOW THIS UNE. <br />DTSC SMA (9/96 <br />w3A 8700-221o1L.w; GENERATOR RFI AINS <br />