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kli �j r• Too inir neAIngnn+BY{e ll�'V_ a kileal Foran ADDroved. OMB No. 2050-0039 .T UNIFORM HAZARDOUS WASTE MANIFEST iGeneretorlDNumber r.^' h C,% {� III out q�' 2. Page lbf 3. Emergency Response Pho )sac LifF3 r '1116' 4. Manifest TrackingNumber 00038849 FLE 5. Generators Name and Mailing Address - . _ Generators Sae Address (If different than mailing address) JOCaC,Uill 1..0 .JUIiCi WCl `a�G`,. ��. iL tl r`1�CI1:15rr-jjb( i. I>,t 1Clr P:.J`,'• Tan 10 SGir1 3(:0U{Cln+•) t'G' 1-1UU�EI�c1CI lA-; C.(SIf: F=GCI�tI 'I SCiC l..:FUt} C' ph C G - �,SO 1 a- U 1(�� { (v�.7 (p Gene ors. hone: ..,x ;� �(p { UC . } Ci :1 2 V . Trans ra r 1 Company Name U.S. EPA ID Numb? r ' liCk n I -ILII ��Gr= 1 rC fN I 1 iCk JFCC:ICL. lr1C_ i�11� Q4 7. Transporter 2 Company Name _ - - U:S.EPA 1)Number .. 8. Designated Facility Name and Site Address _ VS. EPA ID Number C 111?0-I Ikk( V3Cif'ti LT�W 1,'G I1nIE f\I0.I )Fv � PCL -7�o({G P\rnfr-tcun CfrCl� FaddII.IsPho a 0, CiC fir'• -11`1 3U �`I ZJ -i I .7 A\ "Ia C;�c� 1 k ICI -. 9a, gb. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit 13. Waste Codes No. Type HM and Packing Group if any)) Quantity VVUVO. ' 1,Flarrm0Lble 11�jj�d.l� G -S (Thrnrte(,II rolrv:» tcl� of l>rSkgltcxl�jC1-\Ikvbr)),'s1WIlkctcj vGT1 (erci' ati;) F' {� W .K 17.1 t-t't -IL 4.1 p K w z. Flanurvr0.1�1€':j�,1�ti5,Ur'c�anr4,n.u.s.i(F2.es1,�5. A ,(pl. IV C.1hN.Sf v t- C N H VV) '-A Ur)13 .5(16 TL CC-rq•1 (_fF 31'Gy G-;Ci,hnr0.1]I t' ItG.0 1C1 Ir L V t C., Il. U- 5.C�`y r P'IlY rift b y �IgZ'1,1C'Yi\A"N ,3,(Lo. I)'UI)IwG2 PGTS'(E'fC`:13t) °.cur rvsfG v (, �A cl,bc,�tL,Ur'Qntc,r�.U.S., (GIVAckl 1� I11e.0 1) ulc' Z. Cul e) ,i5 u 13� lu l t PCA ]S 0o' 1 I(`% ? 14. Special Handling Instructions and Addlbonal information Fl4.14c;kt9I'-I_a X n1i'�Cf= 3.) c tAQ-4 c aa - X SS 6111 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,: and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable International and national governmental regulations. If export shipment and Iam the Primary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. I certlty that the waste minimization statement identified in 40 CFR 282.27(a) Of I am a large quantity generator) or (b) if I am a small quantity generator) is true, - Genera c Offerors Pdntedrryp ameigna ure on ay ea rvw r Uo as 0� Z11 TB: International Shipments - - import to U.S. ElDriedfrom U.S. Port of entry%xiC Transporter signature for exports only): Date leaving U.S.: w 17. Transporter Acknowledgment of Receipt of Materials Transporter 1 Pdntedfryped Name Signature �J on sy 7ear CIL G loanspoder? Pdnted(Typed Name Signature n ay ear } 18. Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ ❑ Type Residue Partial Rejection Full Rejection �Jt bine I'I. a 1, c Gf ll,, �; n E "quo f� (; (x ?/ g/ FGb' U' �+ /) '+'ln iS 10'V Q t+' Mahifest Reference Number. [= 18b. Alternate Facility (or Generator) U.S. EPA ID Number U a 18c;;ZElgna9ureefAltemata Facility(or Generator) Month Day Year ' Id N 19. Hazardous YVaste ReportManagement Method Codes (i.e., codes for hazardouswaaste treatment, disposal, and recycling systems) - /l 20. Designated F Illty Owner or Operator Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Ptl,1a�rriy N e'[. `; r"-- onN Qa Ye f- I EPA Form S70- (Rev.3-051 Previous editions a re nhsolate. nPQIrklATPr1 Peru ITV Tn rPMPeerne