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NOWN AZARDOUS WASTE MANIFWT <br /> Please print or type (Form designed for use on elite(12 pitch) avrrfter) <br /> NON-HAZARDOUS 1.Generators US EPA ID No. Manifest 2.Page <br /> WASTE MANIFEST Document No 00443.02 of <br /> 3.Genorafore Name and MallIng Address <br /> Swift Raofing <br /> 1930 W Fremont St <br /> A.'Sfate raansportera io <br /> S.Transporter 1 Company Name e. US EPA ID laurrlber <br /> AME&MCDED CE M ECAL TRANSPORT 19C CAR 000 070 540 B.Transporter I Phone 1-86&333-9222 <br /> 7.Tmnsportor,2 Company Name 8. US EPA ID Number C.State Ttansporisrs ID <br /> D.Transporter 2 Phone <br /> 8.Designetad Facility Name and Site Addrasr,. 1U; US EPA 10 Numbar E.State Fao1S{ts 10 <br /> S HmlogyNerak Inc <br /> O.Box 578,Hwy 95, 11 mules S.Beatty N9'T330010000 F.Facilltlrs Phone I-$00•-239 3943 <br /> espy NV'89003 <br /> 11.WASTE DESCRIPTION 12. Contelners 13, 14. <br /> Total [lrsft <br /> No. Type DuanlIV WtNol. <br /> Nam,HlwdousWiiSte,Solid(Soil r=ings,) � t f� <br /> 1 P <br /> J � <br /> E <br /> A <br /> T <br /> O - .. <br /> Lu <br /> h <br /> G.Addlilonal Descriptions for Matotials Listed Above H.Handling Codes for Wastes Listed Above <br /> 0 <br /> N15:Special Handling Instructions and Additional Information <br /> 0 <br /> z <br /> ii <br /> 15.GENEFtATows cERT1FICATION;l hereby certify that the contents of this shipment are 1u119y and accurately described and are In all respects <br /> re !I <br /> in <br /> .proper condition for transporl.The malenals described on this manifest anot subject to fedaral hazardous waste regulations. <br /> _... Date <br /> Printedrryped Name 81 Sur Month Day Year 1 <br /> T 17.Transporter f Aoknowtedgemenl of Receipt of Materials ]Date <br /> A Printedrryped Name v- g to •Monfh Day Yaar <br /> N <br /> 10.Tranzporter2 Acknowledgement of llacelplol Materials Date <br /> R <br /> T Pdntad/Typedtfame Signature Month Day Year. <br /> E <br /> R <br /> m Discrepancy Indication Space <br /> F <br /> A <br /> M Faculty Ownef or Operator.GotilficaWn of tk—etpl of the waste materia%covered by this manifest,excdpt as noted In Item 19. i <br /> 1 Date j <br /> T Prinledlryped Name Slgnetur c Month Day Year j <br /> Y <br /> 4 <br /> OF14 02002 .t.A1L£U$WTMG.1600 t•5668.www.latietmsstertam - ��iartxycEnnxwrL�t 5 <br /> {I$NRrL1'PfMM. IWt <br /> ' J <br />