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From / / P- 006/008 <br /> W. %fAST,,,E MAN FE T <br /> NO RDOUS <br /> Pleas�..:prir�t.or.type (Form cles sed for use on.d(he,(12 5ftch)rypewnter <br /> '" .� ,R S1.Glenerator's US EPA ID No. Manifest 2,Rage't. <br /> i .. :1 ., , : Document No.1S:::E all�'�ES�` of <br /> 3.�ieneraior''Nari�e and Maiifng`Address <br /> A-G1�I.M. . . <br /> - <br /> '4,Cert'erator'.s.'t'lione <br /> S.Tr"porter.I:f6ornpany,Name 6. US ERA:ID NumberA.State Trans rteesID <br /> 1..r <br /> _f el, <br /> -•; B'Transporter 1 Pilose �. <br /> 7.Tratisp..rfer 2 Carrip'any Name US EPA ID'Number C.State Transporters ID <br /> D,Transporter 2 Phone <br /> 8.Das:rgnetod Facffityand Site-Address Its. US EPA It;Number .E:�tafe Facllys ID <br /> JO <br /> .XI i• ti ?.;.. `,•: may: <br /> Y F.Faclllit/s.Phone <br /> ` : , B 2 .7 32 " <br /> 11;WASTE DESCRIFgO*t4�• ` <br /> 12; Containers13. 14. <br /> Total Unit. <br /> No. Type Quantity 1Ni;JVol. <br /> AR <br /> RWme <br /> 011 <br /> d: <br /> �a.Additionat-Desctipbons for Maieri.als UBted Above- H.Handfihg'Cbdes for Wastes Listed AboVe <br /> V. -MI <br /> , .' AlOft <br /> r _ : - <br /> . ......... <br /> IS:Spebial,Handting Inotructlons and Addtdi n'al Ihformatlon <br /> �������ttyy , <br /> ir+ f. <br /> Q:'•" � q�yds ��'�•• <br /> Z:�. <br /> Aw W- AVAW A W m�V-A I M <br /> AW AIF AW� A; <br /> 98:AENERATGIR'8'CCERTIFILATICIN:i h eirei y:'certify.#ttat-the,contMts of this shipment-Awfxltiy and adWrately. tib�ed end ere in ali respects <br /> in„ r cx7 <br /> properulition toc nspoh.l he `taiWs dmbed on this manifest and not sul�gec#:to.fediwal�hazarid6ius waste regulations. <br /> Date <br /> Printad/1 rpad Name S' use �• htontta Day YW <br /> AM <br /> "-J 'T` 17.Transporter 1 Aouvy4ed®erni-if-.Receipt 6f Meter al , .Date <br /> A Printed(i"yed Maine j Sigrtatxir + htortth Day Year <br /> P^" 18.Trar> orter i2'Aoknowiedgemant'vf:R of N4itenals Date <br /> :�D� iPf ` <br /> T' Prlrried/7yppd'Name Signature Month Aay Year <br /> 'IE <br /> R <br /> Qiect'epaney Endication$pacw <br /> .:Fx. <br /> 20..Faaltty OtNner yr C�p+e�*or'.Certificatlon bi rers.�pi:cJ the waste'm tenals ccncar+atf by'tfitls rnanrtest,except as noted in Item 19. <br /> Daie <br /> S' nature <br /> P'r�tedri`yped•Name' r r9 mcwvl Day Year, <br /> Y*' <br /> CF14 2Qo2 l�ir1g'EI:�`"''�ASMO (boo)62t,58o8.www.labelmaster,corn '"w naw nx�a� ►►.w„M <br /> usr+n +rte r�wc <br />