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Feb. 23. 2015 10:24AM ORGE W LOWRY, INC No. 1216 P. 1 <br /> Plaeee' rinboy ;Pofmdesined'forutwbh!ollW..(1R-Wl)"Mdla:) ` ... ..'. <::." ,,.-;,FOIN Mgllp•: p p3B.,`•: <br /> UNIFORM HAZARDOUS f.GsmartodlD Number 2.Page l of 9Emorgmoy Response Phone d.Manifest Tracking Number <br /> WASTE MANIFEST -1({CdYR14TJ1+3 '1 ;. 013435157JJK <br /> •. 6.G qP I�onr an ,jYYhhl ddmu .• Gen ramre9ms'Ad rers In dlmarem Nan mall"address) <br /> 11 <br /> SA1.i6F,;Eia Ls <br /> UP USA, <br /> IVGanerelofe Phone: i?t"+•j4`fPsb:1D::;' .,.,�:,•;;I I,: ,'.[•.` ::.: . `: 'IF:r::rq, .. ..;,. .,...� . <br /> 6.Transporter)Com nY igeme +' US EPAIO aManh§r : '. <br /> GeorgaUJ.�prwTg;Kw ,:v:y . , +. � LAr�D'a70gu , <br /> 7 Transpbrer2 Company Name U.S.EPA'ID Nbmber <br /> 8.De"a lyl*4;911.a71hHTIlI.Wv@ U.S.'—EPA ID Number <br /> f>,it�l CLA:Sla R,U 14, . (-1(7FPdATAACMr <br /> F.(b`ERUANK,CA 963V <br /> Fadi 's.ptlane 2fkti,Ffl3Fhfu$. . .- :. .+ <br /> ga. Bb US DOT opsplptlon(Includlrg Proper Sblpphlg Natoli.Nand Gaq,lb Numbm 1st CoMaAel6 11 T�gl ,12,IJnU 11:Weele Coles <br /> HM and Pecking Gat(if si No. Typo Cost wivol: <br /> It t. NCIN TM:HX.HA2if A07U'S WPJ'i`t1J0U0(IJSEt0:Oily •y ';"FI'Of <br /> ti <br /> F3 2 : <br /> 3. <br /> • 14.Sp& ,0"minions and Additional 1{yb171G'I:74 Z <br /> 5'dd7'AR.4 <br /> lY• <br /> 15. GENERATOR'910FFEROR'S'CERTIFICATION;i hereby dirdare that the co+dams'of this consignm <br /> nenl am euretey deagabove by abby the Pmpey ehlpping name,and <br /> are desalfled,padtaged, <br /> marked and iabeledpl5carded,and are In all respects In proper condelon for eanspod according to appfimda inmmakonaand national gornammentel ragdaliens.If export ehmmenl ends am the Primary <br /> Evader,I certiy that the conlenre of els eonslgmnmtgonfam to the terms of the attached EPAAcknowledgment of Consent. <br /> I testily theles wails -mization amlemenl identified in m CFR 262.27(s)bf I am a targe quantity generator)or(b)(dI Ili mal quem) Ameramf)b clue. <br /> GmaramrslOperoVSP ade - ` Month 0Z YTr <br /> NI? �S <br /> J 16.Inlema60na1 Shipments <br /> ❑ImPodto U.S. ❑EsPaZ . <br /> 5 Transporter signili(for eTporle only):. Date leaving U.S.: <br /> 19 17.TranapadstAehno nlofRecagt d Mehmale <br /> Tfalwpor�r 1 Pdnm ype Name •�enEme, - Month Day Yea <br /> i Transporter.2 PnntedRYped Name - 9iBn, '^ Mon Day Year <br /> 15.Discrepancy . <br /> 18a.D ricer l¢y Indimlion Spars ❑ Quantity ❑Type ❑Resisue ❑Partial Rejection ❑Fu0 Relate. <br /> elaoilest Refemner Number. <br /> 18b.Alternate Fl dliy lot Generator) U.9,EPA ID Number <br /> 7 , <br /> LL Fadhi Phoiret <br /> W 18c.8ignaWnra Allemae Facrliy(or Generator) M. I Day Year <br /> a <br /> z <br /> • 19.Na2eNo11a Waste Menagamenl Method Codas(.e.,mdse for hazardous weete tresN:enl,disp:pael,and reoYtenA systems) <br /> 1 i <br /> 7G /20.Deslgnatd FacPM Owneror Operator:Clpt of haramous masdals eaemd by the mendesferreptas nod in Ilam lee <br /> Pmledfryped Neme �• natureM.m��/ . <br /> EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. TRANSPORTER'S COPY <br />