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Feb. 23, 2015 10:24AM GORGE W L " �1
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<br /> WASTEMANIFEST CARCdSSif MIS '1 2e"k3:ElY,S-37i,Y, �'Y.n
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<br /> R11r`-RU NM,CA 96367
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<br /> fd.S lD fears wsandAddilional lnfarma6on '� 5 _
<br /> 15. GENERATOR'BIOFFEROR'S'CERTIFICATION:Ihere"clawlhafNe cantanla'oflhisconslgnmenl.ro.fuey andesualelyd.gttied above by the papal shippin name,¢ldaledO%IflEd,packagBd;
<br /> marked and fgbeledlplaoarded,ami grain all aspects In proparwndirion for lrarespoa9=10g toappficaUlo ulmmalionatand nallonelge4emmentel regulations.if ecpod ehipmentapd'I am be Primary
<br /> upat(ey l carDWhat the anlenNptNls cunsiglmentpor&gs to the tams of The attached EPAAcknowledgmem of Consent, - ,:.
<br /> radiF/Natlhewesle mizelion slahmantiderfdiodin do CFR26217(e)(dfam4fRigequanRt aene,alloor0)(11 oma snag quaNl,cgenerawQ is we. 'y3'
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<br /> �i Tansporter signature(forespat(i only):. Dateteaft U.S.;
<br /> �-' 17.TanapadsrALWro enl alRecaiplalMatedaie —y ' • '
<br /> Transported Pdntedlfype Name - signeWre <i <' -^�, Monty Day Year;, •-
<br /> W TanepodBl•2 Pnnled,fypad Name' Sign �' Momh Day .,Year.,
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<br /> 18.Discmpanny -I
<br /> 19a.oisvap.ncy lndi�fiun Spare 1�Ogan'rIy ❑Type 'EJ Reslduo ❑Padiel Rejecl'mn ❑Fldl RejerSon
<br /> Manifest Reference Number.
<br /> 1Bb.Almrnd6i Fecialy(oi GenummrJ U.S.EPA ID Nomba
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<br /> ig.Huhldous Waste R dMenegement Method Codas(i.e..cad°eforheuldous want.deeMent,dispoadl,end re¢ynrng syatems)
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<br /> 2g.Oeslgnal d Facgity P,maw Opamlod Ca,G6ra6an, f mcelpl of ID1Lvdousmatedals'ravered by the mendeatatreplesnded in Ilam Ise
<br /> Pdntedlfyped Ne moa/ „ naNla �: M1'anlh 'De Years
<br /> EPA Form 6700-22(RBV.3-05) Previous edigons are obsolete. TRANSPORTER'S COPY
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