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HIM <br /> Se+"• ".`'^app''^ - a�- - `�•' <br /> �'kir• ^,'L-ra s. rw.� ' k "r" • <br /> MAC <br /> 01 <br /> ,ty�� q,,y: � R k�:�•e -�.y�v.� � ]t fie <br /> IM <br /> s µ,;iYeY > y5er ,,� tlSr .37.k I i Y. •jin ,r -f, yF <br /> .i3y,'y.' T c- :^•Ti- fi A. i '% .y'M' - u^4'.' w5:;':_• .'roT <br /> S Slate or Colilomis-#in%oh and Welfare Agancv Gn .,tmenl nr Nwn4h.^••,•c <br /> Fo•m APprc,ed OMB No 2050-`1019(Erpire•g.3D-gt) See Ing and Front <br /> on Back of I`:1gO 6 —c Sub.tancea Coalml No, <br /> and FTont 01 Page 7 r�)�r v„�.,m,nl31CAW <br /> Pl.av DrA!or type. Fo.rn dnagnrd rw vee on elite(f2pilch ryDewnrerl. _ I [_ 1 J,-1 1 <br /> UNIFORPIA HAZARDOUS t-Oaaeolor■US EPA I{]No L1nmw,1 ? i na� snit•`` nan•r in Ihn shndnd„res- - <br /> Dnrum.nl tre <br /> WASTE MANIFESt . oq drnd by Fnd+,rtl hr <br /> S, Oanaaler a Name and Mn,ling Address / �� A. $I.M nilnal Document Ito - <br /> ;,.+,G.neralnf a In <br /> s. nar�p�r�rlQ11.J .4 . zo7 ` <br /> o S.Tranapoder t CmmFany ti me 6. .5 FPA 10 Nnmb,r C. Srnln 1rarepwrwr in <br /> n r . 7F�3 <br /> OY-R <br /> CP <br /> 7. rranapaner 21'—pony Ame / US EP w NumbM E, $tele hanagOr r^T <br /> OF tr rin.Part.r.t'h me <br /> v 9.Derif <br /> gnatetl Fnrd,ly Ilam.and Silo Address 10 US EPA lU Nur.+bnr G. Slate F.c-llly'a 111 <br /> J Eriekenit. inc. �JaII .--- <br /> 255 Parr Vlvd.PH <br /> H .r,tlrt e <br /> O I7 T;nnlA inern 17 101:1! !A I. <br /> (n 0 11. Il$OOT Bwlrrrrli"Ihirh,dlnq Proper Shipping Nam.,ti.rard Cl—,and to 11—h-11QvA,ht. .nil Wrrte Nn. <br /> NO type ttiuVol <br /> J Slate <br /> +oI J4 "Waste Empty Storage Tank _ 512 <br /> r" EEPA/014m ' <br /> V 3 N AW-PCRA liarAr �_ <br /> (3) <br /> NE <br /> h, v"''..v. Stele <br /> A <br /> m T LPA[Olhor <br /> Stela — <br /> ' EPAi Chhof <br /> d <br /> F- State <br /> x <br /> U <br /> EPA1O1her <br /> U, J.Additional OeacHotlone for Matedele Llaled Abs" K.Handbag Codes for KARles Listed Abo.@ <br /> V a. b. <br /> Qt;1a� Empty storage Tatfk s <br /> M � � : Tank (a) him been inerted W <br /> i Vrr Ice per IG00 Gale Cmpatitya <br /> 0 <br /> F 15.Special Itandllnq Intlmcllona and Atltlllloner Intgrmatlon <br /> L <br /> � XeeP away from olources of 19nit.lnna All-rax4 'Weer hardh.its whrrn working around <br /> MaTa Te 24 Hra Contact Name 7,5 <br /> 4 16. <br /> U <br /> OENERATOR'e CERTIFICATION: I hateby declare Thai the cnntenls or this cOnslgnmenl ate fully and.certainly described nhnve by proper.hipping name <br /> 't 1 and are clesslRwd,pricked.marked.end labeled,and are In all respects In proper condition for transport by hial—y Ace elinq to nlmhcnble knlernMlonnl and <br /> a natlenal govwnunnnl rwdalallona. <br /> � ff <br /> 111 am a large gvanllty 9eneralM,l Certify that I have a program In place to induce the volume and Io.icily of wanre -led In the degree 1 hay`determined <br /> to be sconomicnfly praeriCAbre ahnnd Thal I have.asci ad the predicable melhod of heelmanl,Dior@go.or disposer cunrrllrr++lly era,l,hle to ma which minlmlrea the <br /> Present and lulure Iat to humeri hasllo and the environment;OR,it I em a small qunntlty genera <br /> tor,I hero mAdn A good Wit,etrnd to minimize my wnate <br /> l U genstalion end snlact!tie best west@ management method that Is nveuribre to me end that 1 can effold <br /> r x <br /> to PrIttedr Typed Na— 51I➢ewlVre Af-1h Flay font <br /> w1 1 -1 4 I 1 !.'•ri r- r <br /> I IT. Transporter 1 Achnowledgemeal oI Receipt of Materials - <br /> = A Prkrl sped Neme Sig r k(unrrr Day ya., <br /> N <br /> O D <br /> tv 0 16, nnapor r 7 Arknowledgemonf OI RCc Ipl orMalarlslo <br /> q A Pdnbdl Typed llnme 'Sign.lwe T Afonrh Day tent <br /> V E <br /> S I <br /> 19.Dlac,opsncy lndlcalron Space Cry - <br /> ���� 1 <br /> 1 <br /> L <br /> 1 70. rocihil,Owner or Opnr.lof Ce, Ibat n of rae.lpi of hazardous baleriaia cdvofjay this man-fell e.rr f as nolno.n IIA.19 _ <br /> i <br /> yPrinledl Typed Name I Signatur / ��r p-� ��., Lfnnih(lay�F�r. <br /> cr <br /> D119 8022 A Do Not Write Below chis line l 1 <br /> EPA 8100-22 f <br /> (Rev,15.80)Prevtove edltlorr.Are nb o,aln <br /> ( ..II. trwr.r �I..,. nrM,r , I•.r•nlTp+.Tnf!:YIII11))7n I:r <br /> . CTION or THIS _ <br /> DOC r c� s <br /> ,. DUF To TM <br /> QCWITION or" TEGIIyAL, <br />