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Obi 02,'2018 10:37 (FAX) p, 0.551,065 <br />c� <br />NOIV-HAZARDOus 1 amw for ID Number 2. Page 1 of 3. Emery y qyp Phone WASTE MANIFEST :i ii, r��.a+ ,�•,�� - 4, Waste TrM¢IdngNumber <br />S. oenef ore armend Met Address �. fderr#ratarsV <br />fAadtetiA ,�,�'L{,,,��%-�j� Ant`thanmanh`piaddsnee) <br />a6netei,lf <br />0. T neporter 7 am 1 <br />U'S: EPA ID Number <br />7, 2C nyNem <br />U,S. EPA fD Number <br />i3. Declgrmted adflry Nemo and Site Address <br />U.S. EPA 0 Nurriwr } <br />lFadIty'sPhow: 4 / d J ij i+w �:•% $ <br />9. Waeto Shlpping Nem# and Deaedpdon 10. CofNalners 11, Total 12. Unit <br />No, Type Quantity WUvd. <br />r -12W uIC&I <br />1 <br />2. <br />P <br />4. <br />13. $"1 Handling instrudtons and Additional Information <br />Ei�lVIRr P'<ME►NT <br />HEATH Ja;= A? -r T <br />14.8ENERATORWFFEROR'S CERTOCATIONt i hereby ware that the wdenta of this COM10ment are tupy and soouraiery daw bod above by ae proper shipping name. and are dasstfiad• packaged, ' <br />mak#d end Iebele,41&oard#d, and are in all nspec(a In proper condition for transport sccordng loeppltcable Inturnationai and national WMMOMI Mgu�l one <br />Qe tore/ONer a Pd Nems Signature A1oMh D Y#ea <br />� s ,, r <br />r <br />i6. tntemadortai Ipmwa <br />�impon to U.S. ❑ Expon from U.S. Port of enhy/ext: <br />Trane ar sure or a Data issuer U.S.: <br />10, Transporter Ackpowiadgment of Receipt of Maledeie <br />Transporw 1 Pdnl Name <br />r y <br />?1 %fttu Mont, I ft I 1i 7e� <br />17 <br />12 t7uanitly ❑ Type <br />I7b• Mom % Facility (or Generali <br />`aetg 's Phone: <br />7c. SOMUrl of Allamato Fedtiry <br />L Designated Faoplry Owner or Operator. Cerifflwon of rKW of materials covered by the <br />inteCrrpyed Name f f <br />LS -C 5 41979 (Rev. 9/09) <br />r' <br />n t•-� i <br />I J Raiders ❑ P.&M Roadion U Ful Re(#d on F' <br />Merjfeet Refereno Number: <br />U.S. EPA ID Number <br />MMfh Day Year <br />as noted in hk 17a <br />MvA <br />'roaaeennnr�n ar �: <br />