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P!vn,o peoll or typo. (Prilln d0niln.d for ijs,nn...... 112.1wchi <br /> F5-,T. ;--I E-5-0-U—61-1—=41,I VT71—or-S TJgTIT,��= <br /> all I I !i: !i 135;11:1 <br /> T -)0D I q3 qoCon I,n^No. not required by Federal <br /> Nt IF SS li'� L of <br /> WASTE A! <br /> Ra.75�Lmjmoh, /7, <br /> A od A.Stlijo NjanitoSt UoCU.."—Number <br /> Of <br /> I it <br /> 1 241�2 1—. 1� l�l U. Idly GuOUf Sler`L ID <br /> - ,�n5poF5r..1 Cufnpuiiy p; nobar" late Cali <br /> 4. Generator's Phone <br /> Of L) <br /> 0- j 17 n 9 <br /> S'D W.fi—liciporrof <br /> 7-� <br /> transporter 2 Company emu G. <br /> US EPA ID NumburE. t to tons on r"' <br /> Jr.I transporters Phone <br /> N.—00-longiza S V A-d-drass `1677 US EPA ID Nuoribur JG.Stow ty s ID <br /> Lrl A D <br /> L7 0" W Q D V)Aj <br /> acifity a ihono <br /> 7 <br /> 7, <br /> Yl 2.Comaiioars 13. 14. <br /> 11.US DOT Description fInciudirig Proper Shipping Name,Hazard Class, and ID Number Total Unit <br /> ye <br /> No. IT 0 Quantity IAVV, to No.I <br /> 0 <br /> E a. 4: <br /> Fit <br /> 0, <br /> 1Z ty Lot <br /> E <br /> R <br /> A b. <br /> T <br /> 0 <br /> R <br /> d. <br /> tar w, aja -.cd Above--ffa K.Handling Codes for WastesListed Above, <br /> f ; <br /> L;:, ioiao, <br /> 'ps for ev'cy et I <br /> de <br /> d Additional information f. <br /> -7 47 <br /> DiLl <br /> T—,2 C %le <br /> 76 <br /> s of this consignmorK.are fully and accurately described 71-999R-A��., L( rRTIVNC;+TjOrJ:I fiefabydocInini that thoconlont <br /> respects In condition for <br /> above by proper shipping name and ora cln-�sifisd,packed,marked,and labeled,and we in oil respects Inpropor <br /> transport by highway according Io applicable intafhational and nal.orr1l ltovernmental roput Lions. <br /> Data <br /> Year <br /> Month Day <br /> rinted/Typnd Hurtle �Jflul 0 12 1(T <br /> rf V_- Dato <br /> T 17.Transporter I Acknow:adLemom of Rocoilil of Materials <br /> A )-al-rl Month Day Year <br /> A Nintod/Typod Nnino Signature <br /> or ltocopt of Matorals <br /> Month Day Year <br /> - Dale <br /> (� Signature <br /> PonlIE;typed N a <br /> 19.Discrepancy indicati011,Splice <br /> F <br /> A <br /> c <br /> Facility Owner or Operator: Certification e <br /> of receipt of hazardous literials covered by this manifilst except as noted in <br /> y flora 9. <br /> i nntwo Month Day <br /> tinted ypLd Nan,q <br /> 30 DAYS <br /> �jue: .;.;':U5 -JHIi CO"y -10 00"S <br /> rt ps sri A 17/04) TO: p.O. Box ei.00, Scicrcmznln, CA 95302 84 r-1501 <br />