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Teri <br />FORM #FS-UHWM <br />(EXPIRATION DATE 9-30-98) <br />UNIFORM HAZARDOUS <br />21. Generator's US EPA ID No. • Manifest Document No. <br />22. Page <br />Information in the shaded <br />WASTE MANIFEST <br />areas is not required by Federal <br />(Continuation Sheet) <br />6 4 1 2 $ <br />aw. <br />23. Generator's Name sax' . aaqurw carmrri <br />L. State Manifest Document Number <br />WMIACM TA ILL tat,) C. }YTSS.T.T Y <br />it�23e`1SB <br />2128 FYnn� HON} STOMTON, ra, 3S^0} <br />M. State Generator's ID <br />49*17 WA a4 ATTKc 62D96Po1 aarr WL <br />(2.09) Silt -t1776 (2011)6#111 <br />24. Transporter_ Company Name 25. US EPA ID Number <br />N. State Transporter's ID <br />O. Transporter's Phone <br />26. Transporter Company Name 27. US EPA ID Number <br />P. State Transporter's ID <br />O. Transporter's Phone <br />29. Containers <br />30. <br />31. <br />R. <br />28. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID NumberJ. <br />Total <br />Unit <br />Waste No. <br />No. Type <br />Ouanti <br />Wt/Vo <br />a. <br />yyn <br />sll C, VODITi. CAVA -o. ik,=on .$) CT.. e+ud :ar c;.e,•} <br />asg: t2K}, SFr': 743526) <br />I <br />b. <br />rRIMf <br />HHf&T'a7s AiA"pRIAS,. 3, 71N3261, HG 22, 4ID-11624), (arg: <br />2e). (pF: 1-91,41011) <br />61L <br />(\ <br />50 <br />Ir <br /><<t . <br />r <br />"At <br />C. <br />-TA1 e;TFK-'IT.' rTVkTTI`1VM,£. 5.1. IAT:r 72 ,. rX/ TI:. <br />40) - iPE: 1744491) <br />_ <br />�Q ( <br />e.. �: ... <br />61A <br />NA <br />G <br />d. <br />XrOiLSxe SnLT.R. 9.0. 3.. E. I, !I. Vi , P•_= IT, flab -rank). <br />E <br />nrgt 1411}. (pc F99402) <br />N. <br />R <br />Uci <br />r <br />0(>a 5 p <br />P <br />k2 <br />A <br />a. <br />I01ZExO Li(r-17o. CLfnBOSIVS,K.n.S.. E.S. (s), lTf3o99, K4 <br />T <br />- <br />\ham <br />i . terga I4O1 - frf= a-9ftdt)2} <br />o <br />M I <br />.• "r <br />62z <br />B <br />t <br />f. <br />STMIDT11, .SOL1:2), TOXIC., 16O.S.. 6.1, 9N2588, PO TS. tang: <br />511(Fet <br />6121 <br />or <br />UaC7 <br />P <br />. <br />9. <br />.. Pc71:Fltd-OAns- v'Tou Tw, 2.1. TIK1075. (.ar.g: 115), tPT' <br />y <br />43532) <br />008 O <br />p <br />NR <br />77 <br />06,7005 <br />L <br />r <br />f/d L-li C4rit/r: Ary n(�.' <br />A(< t t tt? < P".-7 r�J, fir <br />S. Additional Descriptions for Materials Listed Above <br />T. Handling Codes for Wastes Listed Above <br />* 1W 744828 m- les, PihA ♦e 26C, 7.44493 >+ 2HOt $7ed03 r* _'HTD9 <br />649402 N♦ 28r: 744523 •" 290: 744532 <br />32. Special Handling Instructions and Additional Information <br />V.r. PM Axa+ har. Rla rn; fiaaa=ic:x1- rar.�ri-vl r, .tiMar,.yti. YTP, sw^.m£r Qaa apt _z 'K,..r ..: r �-.-: <br />PPP, whl .. {18T.'311 -Y9Cf' I':,5za'dL::F TAS 4e CTq. <br />FKI. 4ib) (1) 1YntTiG. �. tTsasrn saa pGc>fro-3 annntvlrff r -s ^..A Com, t'i3 r'�t ,.+ta ':. S^.. > -.t;-?'-.: <br />5? Ger; <br />T <br />33. Transporter _ Acknowledgement of Receipt of Materials <br />Date <br />R <br />PrintedfTyped Name <br />Signature <br />Month Day. Year <br />N <br />S <br />P <br />°a <br />34. Transporter Acknowledgement of Receipt of Materials <br />Date <br />E <br />Printed/Typed Name <br />Signature <br />Month Day Year <br />R <br />35. Discrepancy Indication Space <br />A <br />C <br />I <br />L <br />T <br />Y <br />