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1 <br /> '51 ii4- <br /> rwame,rhal:lralolliol Aq.nry t v <br /> bUCR OF <br /> SCC 105 <br /> rvtF.m Approved OMB N.,2050-00991Esp res 9 30.00 hVC11005 in• .Fes•t b D pmamoM I f 5 b <br /> <'m!•,I <br /> Pleb e.pain+or type. Form designed far use an Pill,02 ,kN 1,ar—ner, 511111mi_1111__ _ <br /> JUNIFORM HAZARDOUS Gene.tor s US EPA ID No Manileu Doc me !Na� 7 Page 1 a mmbo n!h h d.du eat <br /> ,not .',ai d by Federale, <br /> WASTE MANIFEST � <br /> 3. Gn o Name and Ma ng Address A. Shia Maminf Doc9maM Will 932304701 3230p7iy <br /> d�Gan Generate,s Phone Inc I <br /> d5 Tran1 portor 1 Compa .,-. A US EPA ID Nonni .! ..: " honor',ID /"'• 2j- <br /> Q� Trois' s Phona ra / � <br /> J 9 Lan pone 2 Company Name 8 US EPA ID Nomter E State T a sp h s ID , <br /> O V F Lan p n s Phone <br /> _ __-1�1?1974934; <br /> Z 9. Deslg ted F r!y Name and She Add a 10. US EPA ID Number G`S;dto Fuc Irt,`s ID <br /> m SN 1 J v-"it' >•�t�taG t.�i 1 CU�F. _ 1 I . 1 <br /> 07 30(1 v 1 h 1 �llT r' , ,iX. i H. Fadny Po e 1 <br /> C�! a AK—"- 170a N . [ 0 0 01 4 <br /> m V - 12 Container, 13. Lnal 14 <br /> Z I1:USDOTD pt n(ini Proper Shipping Name,Hii Class,and ID Number; No. T e Oa !r Wt"!a_�1 N tie Number <br /> I a S�. <br /> D - Y( 141..1: 1 RI.CJ[JS NA 7 51.JLX,� 56i <br /> EPA/0„e - <br /> .� E (N1,TAL HYDROXIDE 5iUIx3 ')' #511079 0„ D <br /> 09 P <br /> <'N I R E A rte <br /> T some <br /> m <br /> 0 EPAr� Olhar s <br /> w Stam <br /> Z A <br /> Z d. <br /> LU <br /> V bPAOahe c�� r <br /> ( Z 1 Adddronal Desenphons for Naknals lsrod Agate K. r5ondl nq Cade:%or N rtes +ad A'oro <br /> Ef cd a ¢ STA=, OF ORIGIN C8an <br /> b 4. <br /> fid� 4 A:Slkfl9 W f'- <br /> i ,r fa 7E, <br /> o <br /> r z <br /> -- -- —' — " <br /> p 15 Spec al Haodlmq Iesrr.o ons and Add t oval mfar.a!an —L <br /> ti <br /> Q <br /> I w I rar a?lr _Tr 11y. . :,� o <br /> �I16. GENERATOR'S CERTIFICATION h b d M t M t n l m carni"one" folly and a M ly d /b d b by p p h pp g d (ed <br /> 1 U mr,l d marked,and bel d d a II espec!s proper dl ( ! port by hghway o<co d g I pp.P.1d I d I r t d of...f <br /> I frlarge9'a 1 ty q the I rt ly* I h P q m pl r d M and z ry l r generated t thedegree I h d t - ed m b <br /> eo e <br /> Ily o tc bl d!ha! I h s elected the F t b1 merited t s.o d i t g dip r tiv i o f of t m h Prp !and 'ani,: <br /> I threat to hone n health and+rte en,no.eari OR if.I a mall poonnty generator I have made a q d I ftminimize <br /> _effort to my waste generation and soli the best <br /> a t management lh d th t s a LI t and+h !1 Ponflood <br /> m Y I Sg Ne / / Y r <br /> Prnrp /m % -, /r Momh D Y <br /> 7 l{rJ J <br /> ZV..ire p I A k" d3 r of R t I M t r 1 t M f r a <br /> La P lmed Typ d N c a_ " I dN s ,�.2. s q a e >h ✓ a1 ea a s Y, ;� Mom Y^ . <br /> r i-rJd <br /> w l a IB. lra rte 2 A knowledoemem of Recdpt of Material,w I , Primed/Typed Name SgnoNre Month Day Y a <br /> O. P -- - - 1 <br /> NIIC-P .p onl. .eon Space <br /> Q F <br /> Z v <br /> 0 F c.I P 0/Op em Cut cc of __ of h d n=me' lied by M' msa eCy Cepl a noted in Item 19_ <br /> T P !edr Td Nam 5 g azure �"AontF Dav Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> dwm GENERATOR SENDS THIS COPY TO DTSC MTHI'I. JU D�+S. <br /> DISC 8011A J7,92l <br /> Im. P O. Pa. dW, Sacmmema, CA 95812-U,OU <br /> EPA97M-22 <br /> 03/17/1998 "ORIGINAL MAY IFESTCOPY" <br />