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From: 11/17/2008 <br /> 'AZ `.WASTEVANWI ..­T <br /> r f <br /> Please-Vdrit or e (F'orm,.des3grked-,for use.on eltte:(12 pitch)-typewriter) <br /> C,e}rrera4or'e llS EpA ID:No. Manifest 2.Page 1 <br /> . "D 9 ', Docunlerrt No. <br /> Of <br /> WWA <br /> :3.:Gerrerator'sNarne:and•hrtalting:Ad�iress. • � - .. . <br /> i` •.. i( . <br /> T <br /> 4',Gienerator'•s Phone:o �; +" <br /> ,,:6.Transporter,:1'Comp� py fVame ( fi: :.US EPA ID Number A.State Transporters ID <br /> .'0 B:Trattsparter 1.Rhone :e�► �' . <br /> 7:Transpotter:2 Company Name 8. US EPA•ID 14umber� C.Stato.Transporter's ID <br /> D.Transporter 2 Phone <br /> 9..Designated'FAcUlty Name and Site Address 10_ US 5PA ID Numb46r E:State Facility*s ID <br /> Wiff <br /> F;Facility's Phone <br /> Mill: <br /> '> 1 <br /> 11_.WASTE'DESCRIPTION, 12, Contalners 13. 14. <br /> Total Unff <br /> No. -Type Quantity MI-Vol. <br /> SOIL)A VMS <br /> (a; b. . <br /> $ <br /> c. <br /> - <br /> 'T. <br /> c r! <br /> C3.Addltioih6l DescriPtions for Materials Listed Above • <br /> H.Handling Codes for Wastes Listed Above <br /> Aft <br /> ' <br /> 'llb , <br /> 0 <br /> 10 <br /> If <br /> .N <br /> 15:'Special Handling lnstructinns and Additlon'I Wormation <br /> WARtFM U <br /> CM-. CT <br /> ,.: .. ,2 - <br /> Jaw ' WAV AF AV AW.AW <br /> AW'.—IF.-A. W.' A ANF <br /> AW.AW Awl"YA <br /> �a;�O ENERATOR'.S,ipERTIFICATION.-•I Eby cerMy that Me contents.ot-this shigmeot�eJpl{y end accurately descfibed and are in all respects <br /> l In,proPer.coridition for.transp,ort.The maw teriafs desc ribed.on this rriarii#est are not suNect to federal hez�rdous waste regulations. <br /> Date <br /> Frinted7we d'Narba. f-,. $f re; Month Day bear <br /> e—.,,k,4cz) <br /> •. <br /> 1' 17,Trar�spar r,.l vAckno, edgerrkent of Receipt of Malbda(s D�tq <br /> R, .... St nstut•e <br /> Print edlfyped I>jarne 9 Month Day Year <br /> Up*-W. . <br /> R 18.Transporter 2:Aeknowledpemer t of Receipt of,Materials.gyp Date <br /> R `Pririte rr Name Signature M�fonth Day Year <br /> E <br /> 19;•Discrggmncy ktdicAfion Space <br /> .: 2t7:Fadlity:tflw'he.r or,Qpbrator;09ttffication of.r"pt b tie waste materiels cdvered try this manliest;except as notsd in Item.19. <br /> Date <br /> PrintedRyped•Name 5ignatute Monfh Day neer <br /> X41 <br /> L pmm ow WCYMD WIPER <br /> CF14 0 20Q2 tai-!:1"��►.tY (800)�2iY5$Q8.www.labelrnastet.cam <br /> us.c 501BEx�ilrc <br />