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08/02{2018 10:38
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<br />H�N�HAL4R0008 1.O,neretor ID Number
<br />WASTE I�AMIFF)&T ^ , -,; , 3
<br />6. Gmmtors Nwm and Mallin , ' t r,. ry, I►'tJ :w :.�.
<br />I
<br />bis G !� �.�. ��;c ..,
<br />Oeneniora Phone: r r r
<br />6. Transporter 1 Company Nem,
<br />7, Tralxpotter 2 Company Name
<br />mgwreo FaGaty Name and SAo Address
<br />CA
<br />FAX) P.057/065
<br />p f of 3,
<br />( I^rupm- y R,r / mss Phone
<br />�Wulalky Nmbep.,
<br />x
<br />77
<br />G -- Ws Sit• Addmu (it dorml than maltingaddress)
<br />! .41 'Fv I Z 2. s0,4,
<br />U.S. FPA 0 Number
<br />U,5, EPA D Number
<br />U-5. EPA 10 Nimtber
<br />S. We* Shipping Nome and Dew*idn
<br />1,
<br />�o vti l� Ll X_, r' C( p v l r C/ . C G ((A)CC Crl
<br />4.
<br />13. Special Handlhp tnahtrcNorrs
<br />10. Cwtainam 11, TOW 12. Urdt
<br />No Type OWOY Wt.NOI.
<br />NV
<br />N %018
<br />ff P, 7H f)PPA PT AE
<br />14. CEN&RATOR'SOTMOA'8 CERTIFICATION! I hereby decfm that the contents of this conslpmem are tmey and aoarretey desatbed abom by the proper ahipping name, and an, o1j,"Nat, padog,d•
<br />marked and is mhwVPlecarded, and are in au resp,om In Proper condi N Or transport Aoca dtng to ipplloablo IMamatlrural and VOW goveromonial r,gulations.
<br />OBnerator"Ora's Pmtedrryped Npnte Mom Day Ym
<br />15. Intenretbnal ShfpmeMa to U.S. j Impo, �' �• � L^ -- _� .��=-,LuC_.. _Fr� ,� ' ✓7-� + J f� I f �;
<br />❑ rt Fort from U.S. Port of emrylsxiC
<br />Trans nor SI aturo for onivy, Dan kmft U,3:
<br />19. Transporter Admomodgmenl of RooW of MAMMIA
<br />.�
<br />Tran,porler 1 Prkd,d/T ed Nam,
<br />Mash Day Year
<br />FmOaporter2 PWdedrTmed Naar
<br />77,1
<br />17l.
<br />7b, ANamate FaalNry (or Generator)
<br />!WIN a Phone:
<br />7cftrialure of AN,mats Featly (or
<br />11 O mldy 0 Type ❑ Reakfa,e 0 Partial Rejection ❑ Fu@ RBNcdon
<br />Number
<br />Year
<br />I. usuVlted raciWy OWmr or Operllor, CanWOOOn of ra0801 Of materlals ObWered by the MWO691 except u noted in Nem 77e
<br />Inlad)-yped Namet f ftnaturo Month Day Year
<br />P „±.•C>,, -'t rat ^t,�1 ICY e- 1 _. _..• r f �,,.. r
<br />LS -CS 11978 (Rgv. ar4$)
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