Laserfiche WebLink
PIase pnnt or type.(Farm oeargned for use on elite; 2-pitcnl ewritef i Form Approved.OM8 No.20,50-0030 <br /> UNIFORM HAZARDOUS <br /> I Generatif IO NUTber 2.Page I of 1.Emergency Resporse PfKx)p /,Mariffest Tracking Nurnber <br /> 1005745838 <br /> WASTE MANIFEST J J K <br /> 5 Gag istesRime and Malong Address Genera9Ys Site Address cif di formt IMP Toning address) <br /> 4►1;!G't?TOrJ 1!E.'I;5 vela <br /> ''ria 9 'L1RC!!!'+.• - <br /> 5Tt?t.r`Truf <br /> 3,ener&Ws Brame <br /> a.Trahwater f ComponV Name U S.ESA fl)Num <br /> 7.Transputer 2 CcnrwiY Name U.B.EPA ID Number <br /> R Destmeted Fact Name and Ste Acciress US ESA 10 Vumber <br /> Fr�lihl s Phrase. <br /> Ser 9b U.S DOT Deacrfflion(vu:krdlrg Pr%w Shippf g Varna.Hexed Cass.D 46rnbco 0,Cmtarwrs I I.Total 12,Unci 3 y1'asm Cale= <br /> h1 and Paddrg Group;B any). i.. �e Gerrity At."'al. <br /> 1 ' <br /> � r <br /> p - `' ----- �---- - <br /> W <br /> z <br /> w <br /> i <br /> S � <br /> r <br /> 'a EpuriEa Nandh'q Ins - ms gr4 Addlinral htrmboq <br /> 15 GENERATOMOFFEROR'S CERTIPICATION:I hereby declare It-at the oonlents od IN oanagrmed are My and acaaalely nksrnbee above by fns paper Wwp r,l i lent -r d rn;.tamed,Packaged. <br /> Tarkem and labeledpacarcec.ani are in all respects n p oper condrbor for Mepa(Kcofdmg to apalicaNe mesonawral and naterw govemmordso+egdalions Ito q--O<hcorotK'FIJI ern ore Primary <br /> Exposer,I cerpry VW the cmhenis of this canslgnrrent cordorm loft harms of Ire allacted EPAAckw*WdWW0 of Consent <br /> I oarfvy Mui Mta vne�nrrnalnixm on Staten enl IdandBed in a0 Cf3i 262.27(al(d I am a targe gwnbty gerferabr)ar(b)(Mtam a aeua gnaraey gererarorl Is sue <br /> GifferemlarOespt a `Name Year <br /> rrr.�t .r. <br /> -a 16.lntorralia Shlarn" f-� <br /> Lrprxt m U S L I EapoA Irom U.S. PoA of warwefdt <br /> Tnarspater synalure IV ex3orm rnlyl Dwe WRWV U S! <br /> � " Trarcnrrirt 4;:+nrytikdgrn3n of Reo3pt ca Nalaiats <br /> aTrAftsp.rte 1 Rnted-Typed klarne Sgraturo /., klarth Oay ri,u <br /> ZQ an 2FrnlediTYpetl: ina ! Sgna'dre 11onMi Cay tear <br /> IS Dscrepangr <br /> Ica.Disirepaocy Wicatm Space womtty Type L—'Row. Ll Penin Rafeced. ❑Nil RaIerxcn <br /> 1t'Yilte-:I Rer?rer.e Numter. <br /> I 61.AltemaFp Facility Iof Gererator) U.S.EPA 10 Number <br /> U <br /> W f3dliP,s�Mre <br /> 3cSgreereofAlternateFixIlry!or:xrentor) hlmN Dayr Peer <br /> Q <br /> Z <br /> I:� Repart Management McIIIr'Codab{l.e.,nodes for hazardous waste L wirnunl.dtsl;o+al,and recyclno systems) <br /> LU I 2. 3 + <br /> R NEgnatep Facflly 0wer or Operatt r Carificabon of rete pi cf haza+dnus inaterigs Gwr+ed by the maldest excebtas nded M mem'BO <br /> nl ,.,,sect karm Sigmilum )Airrn Day Yew <br /> EPA pormd70CL22(Rev 3.051 Previous editxins ere obsolete GENERATOR'S INITIAL COPY <br />