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06/17/2009 10:30 5105811102 JACK EDWARDS PAGE 03/03 <br /> i <br /> 1. D•YI 1 <br /> Please print or type.{Form dosioned for use on olita(12-pitch)typewdler.) Fnrm Ap rov9d.OMB no.2450•0089, i <br /> 2i.Generator's US EPA ID No, Manitoat Document Na. �,;iPagg <br /> UNIFORM HAZARDOUS inorinaton:irt tna shaded. .;': <br /> I! WASTE MANIFFSTeioas is rtot requirid by: aderal <br /> Continuation Sheet <br /> 9,3. Onneretor's Name - , L:;State.Maitifest D.ptrument Number <br /> M.'•StBta:'Qpiyerator s;ID <br /> 24.Transporter .,'' Company Name 5.VS EPA M Number N.•St6te TmoS(ioiieYs.D <br /> l l _ };; ,.';:°i ' !' "• ;i 'ti= 0.;7 ranporter!�.Rhon' 1` v,'+,, �` r.°' r <br /> Transporter Grptnpany Names —27.US 90A ID Number' P Sts�te'Tralneapaii$,`e.lt)'""A` <br /> p,';Transporter'a Phoiie <br /> 29.Containors 30. 31. -W- i <br /> e.U$00T Dasoriplion(tnclud/ng Proper SlNpping Name,Hazard Class and!D Ntunbor) Total Unit <br /> WM. No. 1y a .....Quanflty- wwoi <br /> _ <br /> l <br /> h. <br /> S <br /> " V <br /> i <br /> N It{ <br /> A - <br /> a j <br /> i <br /> r, <br /> i <br /> � .. " . ated,Above..: T,':Nandling Dodos for Wast®s <br /> 1-fated Abo,Je <br /> S.AdBitfonal Descriptionsfar Materlals. ! i <br /> I <br /> 32,Spaolal hlandling InsiruCtianS and Additional Information i <br /> I <br /> I <br /> T3.-11ansporter•_ Acknowledgment of Rocelpt of Materials <br /> q -• Dale i <br /> N f'rinfedr[yped NAme Slg ntuee typnfh Day Year <br /> I <br /> 1 } - <br /> 17an.pbrtpr Ackrfawtedgment or Reoelpt of Materials <br /> T Prlhtad e'd Name' <br /> F 'p Slgnatur ~Month Day Yaar <br /> A <br /> 5,Discrepanoy Indication Spare s <br /> T <br /> Et+A Farm 8740-22n(R4w 9.86 Previous edition 1,1 ebsotote 3EN C RATOR COPY i <br />