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NON-HAZARDOUS WASTE MANIFEST <br /> 'Please Pam or lyp9:r. (Farm art for use orS elite 12 pa=h)lyperrdt F ' <br /> 'NON-HAZARDOUS ` . ,Gelreratal tUSEPAIDNo.` mand0at zPaas, <br /> WASTE MANIFEST 1A .. 1 ,. r!Y.�: .:: oocemamrlP:.. : L41 <br /> -3 Gerierelo?a Nerrm end'Malling Address <br /> Gereremra Phonal 1 - •_ .._ - <br /> 5. arteporter I CGIlmeny Neve' -- - - - - 6.-- US EPA ID Numhei A-Slate Tramporiev's M <br /> i;. 1: t �� V 8.;:n;porter;Phane <br /> Lj <br /> 7.-r anoporler2 Company Nemd - - e. EPA ID Nunbei C.State Treasporteys 10 - - <br /> . o,Trensporler 2 Phone . <br /> -hl a1a�f�d�fFF"Yq <br /> J X71?� 3�}e�Ji W .j,y1,110- US EPA I_D Nlnn4dr - - E.SWAo Fectllys 0 <br /> �'E - {(, F. adlhyrs P-r✓/ .: _..ice.. -. }-t e.l <br /> - 11.WASTE DESCRIPTIO!! 12 Contrii.rs' 13. - 1C <br /> Tow U it <br /> -.. .-. No .Type Quantity WLNd. - <br /> MON HAb <br /> b. <br /> E <br /> N � . <br /> - E - <br /> p Cr " <br /> A <br /> T <br /> O <br /> M <br /> } - R.Adtstl nnl 0c6MPtiu ft�)A-MrioLv I dod Ab— . . H.Handling Codes for Was"LbWd Abs . <br /> O I <br /> 0 <br /> IM <br /> M Speciol.siendhng lnsbuctioris end AWticnal blfnm,ation <br /> ) <br /> f' <br /> IS.GENERATOR'S CEWhFICATWN:I herby dM"drat the mneehlsaf OiSZh4nier+tnre hetyandaacuralely dascdtisd aM ars hell—pacts - 3 <br /> s In groper condRLon for bunsporL The materials described an this mamleal ars noi.ubled m fteeddeeral Fmiardor:a waste reguletiola. I <br /> Date' <br /> PlInladTyPad lJemB ... :. - Slgneture f' month Amy Yeer <br /> 1. .. yyf } / Ei j(f / <br /> .� Ifs 4,f o C�+.,,Vt{ _c .TI. / <br /> T. '17 Transporter 1 Acl rctA06U#Mm of Rene 1x of Mmasts ' Dale <br /> AyPed Name-41 Man aY Yeer <br /> k <br /> S <br /> p '18.Tremsporter2Atlmowledgement5t Roceiplof Materiate _ - Date <br /> Primetllfyped Name - .. _ Signeluro - .. - .lR nth Cay Yesr. <br /> I it _ <br /> 1g:D'ecrep—y lndicavop Space -- ..... - I <br /> F <br /> 3 A i <br /> 1' 20,Feclli:y Oi rrai or Operator;Codlficadon of receipt of the waste maladais t—wd.d by this manifns except ae noted in item 19. i{I <br /> t PAmedeTyped Name _ SlgnaWre .Month bay Yeer <br /> r-1ep2002 LABELAASTEAB(800)621-5Wa w Jabelmasler. 'Rei.335 <br /> A <br />