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Arkansas Department of Environmental Quality <br />,?: < Hazardous Waste Division <br />_ P.O. Box 8913, Little Rock, AR 72219-8913 <br />Telephone: (501) 682-0633 <br />Plcase peat tie ry (Form �N7r1ad lar use m eHla (iP-pdch) rypem'adr.) <br />NOV - 4 2005 <br />ENVIRONMENT HEALi- <br />0"9 <br />o•d 79.i1.1 PTw911u .AcTrr•n 11 11 111 <br />UN)FOA51 HAZARDOUS 1. eeneram: s u5 EPA t0 Na. <br />eaaniect <br />2. Papa 1 <br />`9 <br />'81 <br />Inl9neaoan a me anadpd ernes ca ric< <br />0aaumenl Na; <br />-- - . <br />.a9lina by Feeeml torr. ' <br />WAM MANIFER <br />GareraWs Nerve and Meiling Address <br />A SWit M01W 0avmefd N199W <br />AR <br />aw 09AWM CQU. <br />-1-546176 <br />1910 L fAZ S <br />a. S9ee iamarders 10 <br />JIMMIM. til %201 ATSXI =11M "UMM <br />/. G .,ame, Phoma 209 469-3faS6 (209140-U" <br />5. Tarsporo, 1 CmNarry Name a US EPA to Number <br />a Sade Tra rtwomfs t0 y, <br />98111211 •.+a• 7 <br />0. TlaryenaYs Phoma <br />). Tran�atYr 2 t:a*paM Name M. US EPA IO NurMarE <br />SMe Trangaorlrfa N <br />H <br />F. Th na,*1, Phone <br />xMilth 2yattesba Ticauspext 1 34 111, A 1 0 5 31 5 2. 2'3. <br />Name aSae Address to. US EPA M Number <br />9. Oeeglated Facift Nmnd <br />a Sero reoLya to <br />TEWS, L1C <br />309 A1dlIBe1• CIIiQE <br />tl F.'eto 1Phsa <br />9fa @6M@Or AA Y}780 <br />a 4 D 0 9 7{ 0 1 9 211041111 <br />015-7175 <br />12 CeMaertta <br />11. <br />14. <br />11. US 007 Da—vion fl g P.aPw Sftwa`9 Nemo. Ne w Glass erU M Numtarl <br />Tatar <br />Ouanary <br />tlml <br />1, <br />No. <br />T <br />WWtl <br />Wua N. <br />G <br />a. VLANN TB ra01rm4, M.O.A., 3r W1199], PO 11, (1fb-Peek), <br />N <br />(atgr 1201, (pf, 744620) <br />to <br />A <br />0 0 7Dl1 <br />41 315 <br />P <br />ew <br />A <br />a rua6aaert ataz.w.s, tAe>aatrzc, s.o. a., 41.1, Um325, 20 11. <br />T <br />(a;cf!" Mon. Adhesives), (asgt 133), (pi: 744521) <br />a <br />0 <br />R <br />0 0 7 <br />0 t <br />q 569 AP <br />Iw <br />c asp P4C1'20Tm9 I.IDUm, TIANPExL, 7ISEX0, 3, U1113021, E6 11, <br />(pytetLtine, Chlazdmael, (..V: 431), (Pd: 7441522) <br />No, <br />Ajii & <br />-- <br />_ <br />a P'ALp' •*�+___- 3, =263, 20 i1, MOT -ft 9116201, <br />(ecs: 126), (pi: 7K526) <br />tom <br />0 0 2 <br />C t <br />2 6 1Fra <br />U.yd��pa <br />J. Aadulq)u4�fdae�rW. i S6 ar 11331 ,"521 ; (7 M Mb) •• 11C: 740" (5 <br />135) <br />N. Emerge w Re1d9nM Into,mevdn <br />c w 110, 747452666: (2 z etb) • <br />90m2 "Iii Il)/OSRAC <br />--------------------------- <br />(1003555-5066 <br />if no altemate TSDF, return to generator <br />15 Spatial Handing Iremltlims end Additional Information <br />Abet appYvpeiate, FCC •hero beodLUg hi atoll. ort Iai. sheen ie acPA ager pt pas 40 CM 261 -orb) (1) <br />mClesim. m pes4ed aaasvediAg to 49 CrR 173.12b, Jab 91493-V"M Site: <br />7150 S.Mh IDL iS jdgaf=d St. <br />semrem a 93206. 1 atatcr— `2.� <br />III <br />10. O9N01N70M9 CUTIMILLTIM I hwaby declare that Me aententa a10da aanalanj are fUHy aaa a mWay descnbN ab9ve my proper shlppkg nam, and aro clesslded. <br />I <br />padmged, .~. and ebakdlplacsldetl, and am In all reapems in proper cond'Non for transport by lighway ar Ing to appkwda inba.,aartat and natbnel q...o t <br />m9umil, n9 ad! Arkansas abate mg1ae99ns. <br />If I arts a large g0a dity generator. I candy that 1 haw 9 program in place to feduos the volume and IWMIty of waste generated to the dia" I have tlsarmine ee b be aeorwmlcelly <br />precl c" wd that l hew ee witc! t a ptaMeMbla maflmd of treadment, storage, or d4p9sa1 <br />IWffath Marth"1zatt the present and fWUM thread to human <br />h ald, and the arreirormeM; OR, a t am Ua <br />a smaff Qnttty generator. I haw made a rt m minimise my Wauu n milmn and seed the best Warm marMemal <br />rorthod 1*1 is avadable to no, and that 1 can afford. <br />PnMay¢anap tlwosY _ <br />Sgna <br />410 <br />N'T. <br />Tra Saalor 1 AIV.Ilod9 rt d Recalpl of 161a ala <br />ASlpn <br />ed�T�yp�M Nerve <br />Tit <br />awm <br />f-- <br />M1bwna. pay Yew <br />P <br />1,� <br />v '0.5- <br />b <br />O <br />to Transporter 2 Actaankdtpmenl of Rectlpl of Materials <br />- <br />6R2 <br />feWta <br />pay for <br />E <br />9 <br />19. dw"anc7 hntcaton Spam <br />F <br />A <br />c <br />I <br />L <br />1 <br />20. Notify Oerer a1 Operator: Certification at twain of hatartloc toat f" covered oV orb I anaaat re of i es nand In sem 19. <br />Yi <br />1 ,._--- <br />- - <br />o•d 79.i1.1 PTw911u .AcTrr•n 11 11 111 <br />