|
FA 23, 2014,-10:01AM••-�EORGE W LOWRY, INC
<br /> ,., 7213-4,
<br /> =.t`daP@BMIS n�*JauKe' ��i:)�+ )�: ``�,,, ,:.:r.,h,.:,., .,..,.d:,,•;.,:• ;: ,,.-.ts,,ayrn
<br /> :a'4f•-:.'viS:a#:1rJ; R^; .'atjkr..E;ua•WM sd`-•vak: u': 5.4. :i vi
<br /> UNIFORM,HAZARDOUS 1,Gcnemmrp Numlwr
<br /> TEM r•Fsixivs^.,zvv.+tB�F;!:+i;si�5birsr>,'.s4G,y:drxs;+'R6;'},'� ,� � f,
<br /> 2,.Pagoidl 3.EmorgancyWponsa Phone d.Men fast n 9 umber,
<br /> N �..
<br /> W45h
<br /> 6,Densmore Namo am Mmrmgmamea SS�s 9a7d7F;1 1 26r1•P?92M u �y1[[{� -
<br /> Qkeorge%s Lomty,ITEC, 'Ganerarore S'MAddrees(n tllfUM 0mn mairnp addlees)
<br /> Ap 81W 176 8£12*(EFwAw 7.
<br /> SAUDA,C.P. MVM 3AWA,CA 9Fusd 485k
<br /> Generators PMhe!
<br /> U.TansDonorl Company Name '
<br /> �� �•t 'U.SiEPAIDNumbar _y2 iAaWg,IHD. ,
<br /> 7.Tmnspoder2 Company Name aa'+4,fi4A�dtd�+71R .
<br /> ,S;EPAIDtaambar
<br /> a,Dasignal4tl FaN tyName and511eAddroas
<br /> AJVf! 1g tC CT@- SltsAddmss r; APR-.48--2015
<br /> U.S.EPAIb Number
<br /> M K,V ENVIRONMENTAL
<br /> • st1�R9ANlk,vk 9s�T7 .,..
<br /> Fxplye Phone: :xf -j .C1 HEALTH nFPAPTAAFATT
<br /> 9e.
<br /> 9b.U.S.DDT Dscrhp6on(ndudMgPmper 9hipp6�Name,Hazaid,Cmas:pNUMia, .• ,-
<br /> .,HM and Pacbng GrouD(Rany)) •iD,.Comalnen:.•••:,:'a•17.Tdw •: +jyUnR
<br /> No. 'Type amity 'wlNoL •13. Jaem.Codae
<br /> 1'
<br /> lie.� 3 (RRnoui Y: Wilp(W9.3 6I6 .. .
<br /> •Ib Vii:
<br /> 2-
<br /> 3,
<br /> d.
<br /> 4•�.V,,74.3P.aoeFHendhnaIneWtlion;e�MAddID'onallnrmmatian ^ r ) .
<br /> a';', C�1¢G;Yl17T
<br /> vffVidEAC'E@6
<br /> "WAR(3UlVL,'b l{j (
<br /> 15. gENERATORISIOFPEROR'S:CERTIF.ICATION:Iherebydedan In L caprents ofus coaslgnmeld Ilyand at lune e ' p proper
<br /> madoed'and lbh4kdlplawnied,esdarem'ell mgpectsln pm wndltlon forbanapod aaab' Ids N.escfibEd'aboYob Iha ppngrmme;e am• asiL ,packaged..
<br /> Pm mg ppnaabWntomodanoland nellona19ovemmenmlregulatlans,Ife�ansAlpmedt ondlam ePdmary
<br /> Dpoda IwdRa'beet Na rmllonIS Wdde omsignment mnmfm to Me terms of Ute e5sehed EPAAd=Midpmsnlaf GUnaant
<br /> I•cmb'ty)h.lhowasI'm 11112aEdn MemmontldoAlMad in 40 CFR 20227,(#f t l am ehlgegWtgenefzmt of lam a small wnb
<br /> GEnemmrsrOUarors Pddl�lfyped Name ) ()lh g Ngenerelm)fs We.
<br /> gnaNre Month Day Year.
<br /> i6anlamelinreeagipmanlc + + nfll
<br /> ❑anped to U,S, ❑FvDa Som UB• Pft nbyal:
<br /> TreneFodBr5lgbBbire(tor okpord;pnlytl Oa1BIeaYing U.S.;
<br /> 17.Trdnsponef Ac.MWedgmmlarRGoai$ofMEmdas
<br /> Q TreMpmmr i"nua..yped Namo Signature
<br /> Warr Wawa, Mopb f,Day year
<br /> S 9C4 iY14
<br /> Trenepamc Nema Signature
<br /> ' Monty Day Year
<br /> 18,Dlrr+epancy •.
<br /> 10e.Diemepancy lncrirallm Spate ❑ quantity ❑
<br /> h'Pa ❑lleeldae ❑Daniel Re(eWon ❑FUIIReJettlon
<br /> 1ab,ARemmo FadRy(m Goaerolof) Mendasl RemreltceNumber,
<br /> U,S.EPAID Number
<br /> U
<br /> u. FadgsPhone:
<br /> s ' w 16o,SI'Mo0 male ecilly(w Ganemlor)
<br /> Monro Day oar
<br /> ED 1S.Tabrdow Waste Repod MenapagntMeh tCod"(,,a..Wes lot huwdwa wedo besbUnl,Apo*andQp
<br /> reD/cgggs '
<br /> G 12• 3.
<br /> 20.Deeigarol Fedldy Owner or Operola:CBaidwWnotreceipt afbaenNous maladah toverod bylhe ma117e9(aWapt as Adadin Item lSa
<br /> P nle erlwz/,;'g -r Signature
<br /> Y ar I
<br /> FGA Fnrm R71H1a.IRay.a-D51 rallousadidonsare G6sulata. :;d I -Ldl 0-
<br /> 'rwnnrconnreo+c enov '
<br />
|