Laserfiche WebLink
rlease.. <br />ring or uypo. nrorm uesl neo nor use on eine <br />1L- nc :wmer <br />22. Page ,_. <br />...IIIA NYGV.. VIVID YV. LV JV'VVJO <br />P#fIFORM HAZARDOUS WASTE MANIFEST <br />(Continuation Sheet) <br />21. ju ._.ar ID Number r <br />' tI Q�� <br />23, .fest Tracking Number <br />08! <br />24. enerator's be <br />� �cQ�ju Iri �u <br />25. Transporter � Company Name <br />la I, S <br />um er / <br />�t�t) r1�Q 3d 50 <br />P D Number <br />26. Transporter Company Name c 4 <br />27a, <br />HM <br />271 U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number; <br />and Packing Group (if any)) <br />28. Containers <br />- 2g. Total <br />Ouangty <br />30.Umt <br />WtN01. <br />- <br />31. YJaste Codes <br />No. <br />Type <br />crc6I IIu)d, IG)1001�,�lc,n-o•s, <br />urr) tt xI n. tur N dr x, li <br />U0 <br />DF <br />5 <br />-p <br />6 <br />i( <br />!� <br />i�t6{C.�bYY'R�tuC,tl u,LIACrCt,C,llr�0 nlG,fl•0.S <br />Iii drech l ori c�Ai 3�Sc <br />/u <br />�� <br />e rosoi , a. i, un 1g50Cunt virga) uxas{e) <br />er t aco I io — <br />o f <br />F <br />ova <br />Em! d <br />N <br />Yhrr�nnturn �lrirA{ Ccr�ti17IT S �5! NAQOW. <br />PG I! I (�r4: tyu)� F: G 1a�i3i�+ <br />t d <br />E <br />avae�g <br />t� <br />N <br />' <br />X <br />rF c. *rl coni -ii it,, p3iaawu6 h ydruwcl <br />trc�,ele60I(-'5 yr` C. a Uri ?G It <br />r .. r , <br />44 <br />4rtu' syr" <br />» <br />f <br />#a <br />32. Special Handling- Instructions and Additional Information ' <br />C avoro A 3vht (o cHaHa,Gat3 , aX 3c� laF 7.� I X.CG MaiCi+ay�.3�.._._. <br />$ ct•4ay`��vY �x.acsbG `i• cHac,�'��,R ;•`J+11 �.X;3uDm <br />0 iii y Q9 —(-,o5 <br />33. Trans orter Acknowled menl of Receipt of Mete-als <br />�u <br />a <br />Printed/Typed Name �. Signature Month Day Year <br />2 <br />34. Transporter Acknowledgment of Receipt of Matenls <br />P' yped Name SignatureMonth Day Year <br />Ct. L k� CrJ a C <br />`. <br />J <br />V <br />LL <br />35. Discre c ..-.' <br />' - <br />36. Hazardo s ste Report ManagementMemw Codes (ie for hazamou <br />w2ste treatmentdi <br />poser an r1ding systems) f. <br />ll l il— X14 <br />pAForm 870022A(ReeDESIGNATED FACILITY TO GENERATOR <br />