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Fr11/17/2008 09:40 #256 P.004/008 <br /> 2S "EST <br /> AZA DOUSI.-W-A MANIF <br /> .(FcNm-designed for use on'®lite(12 pitch)•typewriter) <br /> :Please•print_or type. '� <br /> %, 'M� 1 'Generator's US EPA.ID No. Manifest 2.'Page 1 <br /> ., htNo. <br /> �.Gerneratoes.-NarinetandlMalg':Ad as <br /> FnwC. a <br /> FIM <br /> Lin .. ' <br /> �.neratos Pune..L. 92h) <br /> br';1'rarwspor;er't.Co any Na a 6. US EPA:I©Number A.State Transporter's ID <br /> B.Transporter 1 Phone <br /> 7.Transporter 2 Company Name 6. US EPA ID'Number C:Mate Transportoes ID <br /> D.Transporter 2 Pho*ne <br /> 9:D60griato Faellity'Nama-and Site' Address 10. US SPA ID Number E.State Faaltty's ID <br /> ; - F•Facility's Rhone <br /> Ka <br /> tel+ <br /> W.ASTE•DMOPTIt3N 12: Containers 93 14. <br /> Total Unit <br /> No. Type Quantity iNt.1Vol. <br /> Ma UAL (ON <br /> C. <br /> d.l' 1 <br /> t�dciftionai I3escriptiorts'for Materials.fisted Above H.@�andiirg�Codes for Wastes fisted Above <br /> SOM <br /> 15:Spacial Kandling instructions and Addlfl6na)tntonni�iflo.n <br /> WRAR <br /> ' jj�`` <br /> AW AV AF.As. <br /> AW <br /> AIF-A- . AIF-AIF AWAV AIF <br /> 16..GENERATOR°S�CEFMFICATIC►1N-1 heri trb)bedif)'.1hatihe.mhterits of this shi,.oo Le f�l and accurate described,and are-in all respects <br /> IY <br /> to <br /> irk pro s condi gn for:tranppoit,'the MatenelS4esO7jied..fl this manifest are not sc��� fedet°al hazardous aVaste rapul�tians. . <br /> •'' T <br /> Date <br /> PHnta TT'yped Nerve Si a Month Day Yeer <br /> ;. At <br /> T. i7:Trans orter.1- AcknowletlgementV-:Re�aeipt.of.Materials Ua a <br /> ti e' !, Signa ure Month Day Year <br /> 'c <br /> �! IF <br /> `16.Tranepottor.2 AcknawkKdgemer�t f'•�#ec:etpt ftileterials <br /> Rate <br /> - <br /> 18. <br /> Name` Signature Month Day ,Year <br /> t9:'Di repanoy Indlcatloo`Space <br /> 20 Faa�try.Qwr r nr OperatoP;:'�etti do i of.•reo ipt at.itae waste matw*s cover6d-b�tt'M rn�hltb6l,im ipt.at note&iMtem l'9,. <br /> Data <br /> A rintep7Typed.nlam1a Signature Mordh: k'asr..: <br /> CP14 0 2W2 f"AM��.G (800)621-5808.www.lab6lmaster.coin p'"��°""�°`�'""'� , •"`" <br />