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Attachment E: Empty Aerosols <br /> BILL OF LADING/MANIFEST 1.SblppefaUSEPAIDNo.(IlApp"doa) DxumenlNo. 2pagel <br /> oI <br /> 3.SNppafs Name and Malting Address <br /> 4.Si Phone I ) .. <br /> 5.Transporter 1 Company Name S. US EPA ID Number A.Transporteys Phone <br /> 7.Transporter 2 Company Name S. US EPA ID Number S.Tram odees Phone <br /> 9.Designated Fadllty Nemo and Sao Address f 0. US EPA ID Wmber O.FadhWs Phone <br /> 11.Shipping Name and DescHWon 12.Containers 13, 14. <br /> l <br /> HM No Type <br /> Tots Una <br /> Q.14 WWI, <br /> a. <br /> In <br /> 8 <br /> N <br /> I c. <br /> P <br /> P <br /> E <br /> R tl. <br /> 15.Spedal Handling Instreclion and Additional Information <br /> iSa.US DOT HAZARDOUS MATERIALS SHIPPER'S CERTIFICATION: <br /> dtls br <br /> Prinod/Typed Name Maelh oay rear <br /> 16b.NON-REGULATED SHIPPER'S CERTIFICATION:I..WIne nuavole 4eealbM above on ma are roteebosd IP rederal ro,Ankas WTransponauon or Dapoul. <br /> PrintedRyped Nam MMu oa Yesr <br /> Y <br /> T 17.Transporter l Ackr Wgemm of Receipt of Materiels <br /> R <br /> A Prinledlfyped Name Signaluro Mmm pry Ye✓ <br /> Na <br /> 7 <br /> P <br /> O 18,Trarwporter 2 AcknpMe09emeM of Receipt of Materials <br /> T Pimle ffyped No. Signatum Moah Day Yee <br /> E <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L 20.Facility Owner w Operator.Camibcation M ranomt M materials wwred by this form except as noted in Ilan 19, <br /> 1 <br /> T <br /> y Pdnled/Typed Name Signalise Marin Dry veer <br /> 1 <br /> GENERATOR'S COPY FORM N0.01-90291(04/11) <br /> 14 <br />