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kyung park 2035 3731 p.10 <br /> Please prial or type.(Form da dined for use an elite 172-pHoh)ty ermitap) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAIARDOU 1.Generator ID Number 2.Paga t of 36nergency Response Phare 4.Manifast Tracking Number / (��/ <br /> WASTE MANIFEST- -• VVKS <br /> S.Oennralors Name Eard ME ingAAdass GeremIDrsSaeAhlracs ltl dltlerentMan rreiingadlYam) <br /> Ce sramrs Phare! <br /> n,e lw I Company N _ - U.S.EPA ID Number <br /> 7,Trmlsporow-MmisnY us U S.FPA ID NwW <br /> 8.Desoalad Facility NW—w aSleAdtlnM //,Il., {�-D ., Iil1,�p-y,�g} y-r,n�$... US:EPAIDNurrber <br /> TT GJ k".Vc:,erl.""t.p ;FtrrV <br /> Faun 'a Phone: ... _. .. <br /> 9a. Be.U.S.DOT Ds icn(aidudng PfaperShpping Name,Harald Class.ID NumberCoots am 11.Tata) 12.Unil 13.wasp Codes <br /> HM and Packing Gtcup aany)) m. 'we Ousnay N9Nd. <br /> AfN <br /> � ,7tV�56r vit d� diJ i i 35 _ I . <br /> i 2 <br /> w <br /> 3. I <br /> 4. <br /> 10. 'lHardirginstu illikarandAdiddicarnal lnfomralon :rt. r_..t� -•....:..._. <br /> 15, lgENgPATINtSPO WSCBtT1FiCATION I heredy declare dtatbe corAentsorft eons6grmentan,Wand acarat*described abore by the pmoersNppirng name,and ate tla .d,packagad, <br /> marked and labeedlip nowded,ar'd are In oil resperls in proper condibon for Yarul,Mau:om1ng In ardiambde international and national govemmemal regulations.If spar!shiptrem and!am the Pmnary <br /> Expoder,I candy that .e contents of this mrsg:meM confirm to Ne Arms cf the altxlted EPAAI:knaxledgment of Consent <br /> I mrily that Max MInlowalon salentemaentitled n40 CFR 26227(a)(B l am a targe quantity generator)aIo)(dl am a srnad wandtr generaloo Ewe. <br /> GnmeJffiorsfoMamfs PA <br /> d <br /> fit ,Typed Name SgnaWre MattBl ay 7Y6a. <br /> : <br /> 7 ?Iraanatnnal <br /> Shipenent <br /> IllmpatlollS. ❑Erpathan U.S PaddeiiYYkdb <br /> TrerepoMers"lue(for xPoss day): Gale leering U.S- <br /> Ell17.TratsporterAnlrmwpd enol Receiptolklessdak <br /> Trenspimer i PnllsdnTYpir Nana Siynaturi MCMI .Day YM <br /> Z Transporter,2 PramNTyj Name " Synalure �Y <br /> GK <br /> r <br /> 16.Discrepancy - <br /> is&Discrepancy lydartio Spice El Ouarni ENPE, ❑R.1d.a ❑Partial Won ffFW Rey n <br /> Uanlest Reference Number <br /> i8b,A8etrela Faolly la endmbr) - US EPAID Ntmber <br /> U <br /> ra+- Facl,tys Plwne: Me* Day Year <br /> w lsc.Signature of Ran,* Faday(or Ganemlor) <br /> ED 19.Hara¢lous wasp nAlaregetltaAMarred Codes(I.a.codesfor lazatdouswasp EbeUnen4 dfapmal,and raayam9 sysMs) <br /> 20,Desgreted FEWiy rerarOperata:Ce>IM�raEan a!recaiptor hazaNas:llmniOls muared by rite madfastesceptas M*d,n pea 180 UcrPt Day Year <br /> 11I P granre <br /> FpASppyng7ao.22(Rgf. d) PreyIdwedilions are obsolete. <br />