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.. .. . ... .. . /vd I 7cs-1 <br /> S.Transporter 1 Company Name S. IIS EPA ID Number A.State Transpaters ID <br /> P (. ' <br /> f14p EST 11VIDO-5 ,L C44 000 /77 5,7 .Trans nerlPhone <br /> �° rico aaI-laso <br /> 7.Transporter 2 Company Name 8. US EPA ID Number C.State Transporter's ID <br /> D.Transporter 2 Phone <br /> .,9.Designated Facility Name anqq Site Address 10. US EPA 10 Number E.State Facility's ID <br /> L/s �cOLpr,� / Gt/4A4, //JC. <br /> r / =45 SOu OF ��/ F.Fecilitys Phone <br /> ✓E4rty7 1/ ?9003 /t/JT 330 010 <br /> oil <br /> 4") asq _ 8,IZ13 <br /> 11.WASTE DESCRIPTION Containers 13. 14. <br /> No. Type Total Unit <br /> Quantity Wtivol. <br /> Y4zAPbd:lU6 zU4-57F=- LieQVla <br /> �G4ten/na, S/OFT/�7�L—R) 0/ 7p 00„200 <br /> G It. <br /> E <br /> N <br /> E <br /> R ` <br /> A <br /> T <br /> O <br /> R d. <br /> W <br /> 7(G..Additional Descriptions for Materials ListedI <br /> Q — A ) H.Handling Cotl¢s for Wastes Listed Above <br /> 70 n� mO�7�7 9158 <br /> V V/ (/JX <br /> U) <br /> 7 <br /> O �/oe /�� -/5193- Ooa/ -✓eno/ <br /> 15.Special Handling Instructions and Additional Information <br /> Q <br /> N <br /> Q <br /> 2 <br /> OZ � ARi APPROPA/4� /PROTF_C77dr— C/C77f 4,—, �{ EQr' <br /> V/ MF_ IT <br /> Z <br /> 18.GENERATOR'S CERTIFICATION:I hereby certify,that the contents of this shipment are fully,and accurately described and are in all respects <br /> in proper condition for transport.The materials described on this manliest are not subject to federal hazardous waste regulations. <br /> Date <br /> Prinlecirrype l Name Signature Month Day Year <br /> XC 3�-o- 4.•CA.460-C X - CS1 0¢1 Ig <br /> T 17. Transporter 1 AcknovAedgement of Receipt of Materials 7 R Date <br /> A Prime irryped Name Signature Month e, Year <br /> "s Qf6ny,�.Q 501pru� l <br /> P p,5 Octn 1 L a <br /> O 18. Transporter 2 Acknowledgement of Receipt of Materiels Data <br /> R <br /> T PrImedrfyped Name Signature Month Day Year <br /> E <br /> R <br /> F 19.Discrepancy Indication Space <br /> A <br /> C <br /> L20.Facility Owner or Operator:Cerliflcation of mcoOt of the waste materials covered by this manifest,except as noted in item_19. <br /> 1 Date <br /> T Pdnredryped Name Signature Month Day Year <br /> Y <br /> CF14 02002 LABELAASEFRO (800)621-5808 www.fabelmaster.com <br /> REG EIVEL <br /> MAY 13 )015 <br /> ENVIRONMENTAj <br /> UC6rTU'l[DA OT1ACSIT <br />