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2-13-206 4:32PM FRO" <br />Sto-e Of C0160mi-9mirotimenlol Protection Agency <br />Ferro Aopfovotl OMB No. 20 d6-0030. (Expires 9-30-99) SOO Instructions on bock of page 6 <br />please print ortype. form designed for use on elite tl2-pitch) typewriter. <br />P <br />P. 4 <br />P"PIMOAt of Toxic Substance) Cam, <br />DO NOT WRITE BLOW THIS 6NE. <br />DTK 8022A (1/991 <br />EPA 8700-22 <br />UNIFORM HAZARDOUS <br />1. Generwor'A US FPA No. Manifest Document <br />�,!I` <br />. Z�: <br />No. Pdgv1_[ _Infw�fion in the shaded area, <br />. <br />WASTE MANIFEST <br />i <br />i'\ ll <br />" L U41; 101 <br />is not re droll to <br />4 6y Federal lo'L <br />f <br />It,; - <br />3. C�Qllorptcle's Nome and Mailing Address - <br />A-" Pa"OnifeAt Document Numb - <br />-Pit <br />B. 'Sif. Generator's ID <br />4. <br />5. Tronsparrini I Comp*ry Nomo, 6. US EPA ID Number <br />C. Stale Tmnsportor'5 10 IR ... ff2dj)'.:: <br />k. <br />6A a ft J% <br />,p� <br />E. State Tr�n__ft,'s ID lReservad <br />isheme, <br />Futility Name and 54 Address 10. US EPA ID N4.boc <br />G. State Faciilfrys ID <br />1). US DOT Description (including Prop- Shipping Now,*, Ho;,ord Cift% and ID Number( <br />13. Total <br />Quantity <br />?4, Unit <br />Type <br />N <br />E <br />R <br />A <br />I I I <br />TStale <br />u.R <br />6PAfQ+f e. <br />d. <br />Stole <br />b. <br />15. Special Hendl;nq Jni1r,uvi*A, and A44;1;0001 Infoomolioo <br />IJDS,: <br />16. GENERATOR'SjCER771FICATION4 I hareby declare that the contents of th;i Consignment are fully and accurately described above by proper ship g nomand oro clua*i fied, pocked,pocked,maila4 <br />and Io6o6d, and aflqirj� oil rospects io proper Condition for transport by highway according to applicable inlernoo;onol 04 notionarnamevertiffletif regulations. <br />If I am a kifea ejuoAfit genoRotor, I cwtily� that I hove a program in place to reduce he volume and t";e;ry of woos goovecr*d to tint degree I have determined to be economicall <br />�ave <br />proti;cv6le and shot I selected the practicable method of treatment, 'Wap, or 4opowl currently available to me which minimizes the present and future threat it, human flwtltrl <br />and the environfrienr; OR, if I am a small quantity generator, I h" made a good fci+ effort to minimize my waste generation and select the boil waffle management method that is <br />I available to me and that t ton afford. <br />Pfiniod/Typch Name 5ignatstrt <br />Month Day Year <br />T <br />17. Trans leelgetrieril of Receipt of Materials <br />R <br />PeKwei <br />AAwb 00Y Y <br />X <br />L L <br />Jpmmooa�r 2 Acknour adjg5viont iTRecuipt of Materials <br />11rinturd/Typod 4ur�i <br />19. Diver*poncy Indication Space 7" <br />F <br />A <br />C <br />L <br />20. Fo6lity, Owner ar ar for Certificajion of receipt of hazardous materials covered by djivmaniNst except as noted in Item 19. <br />Printed/Typed Nam, <br />Signature j <br />Meneh Day Year <br />Y <br />1Z 1Z EZ �22J,� <br />DO NOT WRITE BLOW THIS 6NE. <br />DTK 8022A (1/991 <br />EPA 8700-22 <br />