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UNIFORM HAZARDOUS �'.u.ar'ao oris iu tw. Mammst Uoa ment 2. Perga 1 nFarmvtion in the shaded areas <br /> WASTE MANIFEST ' is nd required by Federal low. <br /> 3. General Name and Mailing Address A. Slate Manifest Document Number <br /> 'VI-I�Lti 4!i- r'�cvv44?.� 45 24087163 <br /> O� :un.Q :.+wcTu�,`n�, � a- s.+ L <br /> ai C:Ji• 1r• �?'v ii TN•1nw7 n- f1 <br /> nA Genemtois Phone ( - F,;- --- -•t 6. Stob Generalar's IC <br /> 5. Tranaparter I Company Name-ri•� V� b. US EPA IJ Number - y - _ 41--] _ <br /> C. late Tmnspvrter's ID eserved.j <br /> p tiC0 .iG{iisvu' ,. D. Tmnsporeer's lktone <br /> xTicS �' y',u, S's � v G ^. � 31 a ! <br /> 7. Trans orter 2 CompanyN e TA <br /> �- p oma 8. US EPA.D Number E. Slate Transpermr's ID Reserved.] <br /> UF. 7rahspa.18rs Phone. <br /> 9. Designated Facility Name and Site Address 1 O. US EPA ID Number G.Stour Facility's ID <br /> ZESOICry Ca <br /> OW :C� '3rr a5> H: facility'sPhane <br /> res- Rich::D na c6rt.t - a NN - - - - - - - - - <br /> 1 V 11. US DOT Description(including Proper Shipping Name,Haza d Class,end ID Nemkmrl n 12. Cantmners 13. Tplvl 14. Unit <br /> O <br /> Z v, No. i e Qudntity Wt/VOf 1. West.Number - <br /> ..., Stake <br /> G Pvvas' a ar 1T}.'Sv s'LLra-: tankN _ O s< '"5";-•• EPA/Other s„t <br /> b. <br /> m E stake- . . <br /> R EPA/011m, <br /> o T c <br /> o, Slate .. <br /> p: 0 <br /> R EPA/Other <br /> a <br /> w d <br /> z <br /> Z State �- <br /> m <br /> V <br /> w <br /> .EPA/Ofher ' <br /> h <br /> J. Additional Descripzvns for Mamrolr Listed Above <br /> 'ry K. Handing Codes For Wastes listed Ahdve <br /> X1'2 v—� A f�,� r PAGE b. <br /> w �•�I - <br /> lbs ! 414tdf <br /> a g:. <br /> z <br /> 75. Special Handling Instredi and Additional Inform hen <br /> Q .,_•.., _ ..':''3 G: 4 �w:::::':��::: ':�E:ti �n.7:3I-se: LlissSeah?,�.- �r` �Z:.95'a;�$ �g: ,se°w..-��':::w: : <br /> Z eVIC-r9en- Iry Contact F,G•Z D:S^q re.4 f Fr <br /> Q16. GENERATOR'S CERTIFICATIOtB Ihemby declare that thacontenh of this consiynmentaro ally andaaumtsdy d.saribed abwe6y proper shipping nvmo aadare classified,pocked, <br /> V marked,Ond labeled,one are in a8 respects in proper eondiRon far t..port by highway according to applicable inter national and noliand governmam mgJ tions. <br /> CL <br /> if I cent a Inge quantlly generator,I cemly ther 1 have c p oggth <br /> ram in place to caduca the wluma and tnxiahy of wosm ganeroted to e degree I have determined to be economicallyY <br /> m pmdimble and that I nave,eleemd des ractiaoble d of methorrevtment,smraga or disposal Currently available to me which minimizes the p..,aseat end Future threat to hcrwn beohh <br /> ,y and the environment OR,iF I am a small quatrity generator,I hme made a good Faith effort to minimize Cry waste generation and select the best waste maregement method that is <br /> C available m me and Ihol can afford. <br /> Zu IF G fednyPod Name s Sigrenture .�, �e <br /> e /9t Month Day Year <br /> w TS 7 <br /> ac T 17. -runs iter 1 Acksowlod amen)Ot Recei i of Materials O <br /> W F Prin!ed/-yped Name <br /> tl n n 5ignvlure v Month Da <br /> w , y Year <br /> S <br /> P <br /> I0 Ig. Trans Ortar2Aeknawled emenl Reeai of Mamrids <br /> A-10 17101 OFF <br /> O r Printed/typed Nome <br /> ya Sign.f,re - Month Day Year <br /> QI— I . I <br /> V 19. Dis<reponry Indicolian Space <br /> Z F <br /> A <br /> IL 20. Facility Owner or Can.,C-Imc.non at mceit at hazardous moterivls ccr,ored by this manifest except w noted in If, 19, <br /> T Printed/Typod Name Signature Sig <br /> Y j Montle Day Year <br /> .J �n <br /> �ayo� DO NOT TE BELOW THIS LINE. <br /> 075Z SD22A II/99h White: TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS. <br /> EPA 37-'0-22 To: P.O. Box 3000, Sacramento, CA 95812 <br /> bl'd V"ZOL601,9L POW40116 - 1 0 3 E9b l6 90 bl 080 <br />