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t i <br /> t F S <br /> l < � r c <br /> 4. <br /> .. 4. Genertitoi'b Pho117l- ):" '�'. <br /> . is Tm- "ortir 1sny Nesta 6. US EPA ID Number <br /> 'PI rJA Lb dZiA 7= �. <br /> I j 7. Transporter 2 Comparryr Name 8. . US:EPA tD Number <br /> 9. DIgnated FacHP Name and Sit Address td. IJS EPA ID Number ( ,• �� a,;, &A <br /> '�L.D # 33- <br /> "tY <br /> 12. Corua[rlere 13. Total 14. .• <br /> 11. US DOT Description(Including Proper Shippinp'Name,Hazard Class,and.ID'Numher) <br /> Quantify UnitNO '; <br /> a No. Type <br /> AAA 14 <br /> Owv fl <br /> t R c_ <br /> u <br /> .f. Additimall.08041 <br /> 16. Special Kandling Instructions and-Addifionef Information <br /> J V <br /> GENERATOR'S CER7'FICATXft'-I fierbDy.-dept wtllat'tha canbenfa'of this eonslpnment are fidly and eceurately described Above by:proper ahippft name <br /> and are eklasHied;ps,6k6d-Iffiaiied,,and�x aia;ln aWreapoots In proper condition for lrenepprt.blf hlphway.accardina to;gpplieapls i gmadonel and <br /> national povernafent�nlatbns:- ' <br /> If I am.-MW�gam,w tan 116W Via1*hff *)0M.V14.-in-pace 10 reduce the vofMQ and toikAY::of waste Sera Ated to-the degree i have determined <br /> to ba eootlomlcalhr a giat'phi<t1ln 1fi*`prMoU=M*,method of treatment,atbrW0*dtapo"'C=ehft ayakbie.to ms.which minimizes the <br /> present et Mare beta t I fle�tlfaad i1fE�srit;.QR.It Cam a small 4u&MHy 9endratof.,1 have made a.good,faith.effart.to mh inize my waste <br /> 9enKatldr end'setect the W&VA ste:.tn usg�eritaMlelftod 11--:sveHable to me and that I:cari�*Jfwd. - <br /> u <br /> 9 PrhdTypedafine _ Sicna Afarrfh Day Year <br /> JJ <br /> - L% . <br /> , ► <br /> J.1 TR 17. ransporter, cknowlfl <br /> dd ' rtceipt.:01V7latumis , <br />-' A PrintedlT <br /> N yp�e"d'Name r gbna Month OsY Year <br />] S f..:ii _ 1 <br /> A 0 18.'Transporter 2 Acklrowled9emsnl;dtAaeeipt'al1taterfels I <br /> L T PdMed/Typed Name Signature WOO Day Year 3 <br /> E <br /> 19. Disco"ancy Indication.space <br /> F <br /> A <br /> C <br /> I <br /> L <br /> 20:.Fa or or-contflcatfon of receipt aza"10"materiels covered by this rdfe except as in 19. <br /> T !P ed/Type me Signature '_ Month ' Day Year k <br /> r,s e022 A(t r66) Do Not Write Below This Line, Yellow:TSDF SENDS THIS COPY TO GEE T(5R V6T N 36 DAYS <br /> PA 8700-22 <br /> ler.9-88)Previous editions are obsolete. <br />