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I <br />Dec. 11. 2015_ 1:55PM GE. E W LOWRY, INC _ No. 2950 P. 1 <br />Please Print ortvne, (Form deeionod forusg en allta M2-nachl'tinnwrrtn/1 <br />t. Generalori Number . l-mIjP1vvvU. vma rvo. Zvau-Uui <br />UNIFORM HAZARD0U5 2 Pfige t of 9-morgoncy Response Phone 4. M�annlfestTra[�kf" umber <br />IV <br />WASTE MANIFEST ^ t (7 li divx�` 2r�D•f ^d; '.306 6 ja <br />5. Generator's Npme.and Ma@ Address <br />� 'Ganeralor's 61te'Addresa (If dlfterentlhan mailing addreggj <br />WN AUR04 , <br />aeneralorq Phone; - , <br />- <br />;—• <br />6. TmnBpartar 1 Company Nam ftilber <br />0"ga W, {x+prrp, Irx, <br />19 <br />' :Transpnrter2Cori any Name U.6:.EPAIDNUmber <br />8. Desiled t'a� 1 <br />l Name dnd site Addre <br />f'�?+'"tsa U.S. EPA 1D Number . <br />:Fadit rs Phone; Fai 3�8J3C <br />9b, U.S. DOT Descitiptlon (Induding Proper SNppiniEtr,tmber <br />g Name, HkA(a gIQN, <br />10,.Gontelnera. ; ..,; <br />11, TOlal =. <br />12: Unit' <br />' <br />a <br />and.Pecking Grpup (A any)) <br />.. <br />Wfivol;' <br />wade Godes <br />No. <br />Type <br />.a <br />� <br />p.'�- <br />,. ktpl�t �rt�'tK''t�rr��'�• �•'� �i►es:i► ' . <br />.: <br />.. <br />:�.,<. <br />1 <br />; <br />2.. <br />�.. <br />:', <br />t:: <br />„ <br />•• <br />�� •s <br />`1�:$Iiecial Handling' nS11UCtionsandAdditionallnformatlon I ,; � • <br />:L �1E 6 rr <br />:'' <br />l5.'GENERAT.bR'BfbFFERojt'S`CERTIFICATION: I herebydeclare %at the contents of.lhls conslgnnrenl ere fully and accurately describad.ebove by the proper sllipping:pame, and:aredaseifiad; packaged, <br />marked and Iabeiedlplaarded,,and are in all raspeets In proper condition for benaport�crrrdinq to applicable inlamationbland nationat govemmantal regulations, I(e�ogsf' pment enii igim the Pfimary <br />F�porter, IrretUfy d131 U'e GonCegT$-or lhls mnsignmantmpform'to the lerrns Al t(�o.atleihed.EPAAc}e oWledgnClltOf.Co t enL <br />.1 aiil".IhBRIIB weate.rrnimizadon:etatement•1doUG 6d in 40 CFR 262-M.) (41 Lm oIargequanGtygene alorj Of (b).(Iff am a $mail quanby generator) is true, <br />' •Gena[ataPaJ efOr s Pdnl9d/Typ4d Nemo" . Signature rUay, : Year <br />�~.. �` •: <br />n t: <br />�iB.tntatnalional.'s IpmanfeLJ import to U.S. ❑ Expert from U.5, Port of Wry/oft <br />.hah.00, <br />' <br />exports only):Data leaving U.S.; <br />gmantotReceiptofMateAals <br />-TreneportecALkn6 <br />' <br />neperter , tl Name . Signature Month bey Year <br />K <br />bi <br />Name <br />ir8rteporlal . �. YMonth Do <br />::�B.Dltiaeponoy . <br />'18e; Dieoreperk y Iniflce8a 6pece ❑ o ant y ❑ vype ❑ Residue ❑ Parwl Re)eptlpr O F' U' l )ac1♦on <br />Manifest Reference Number. <br />19h. Allamala Facility (or Gamrator) U.S- EPA ID Nurnbar <br />�Vc <br />+ <br />i <br />fad! a Phone: ? <br />18c, Igneture o amate Fe or Generstof) <br />Month Day ea <br />1C:'}`iaiardous Weete Report Ma gement Method Codes (i.e., rodea for hazardous waste hatment, disposal, and reoydlrig systems) <br />2. <br />20:•Dssignated Facility Owner or Operator; CeMloca6on 61 receipt of hazardous matelots Covered by tho man fest except a$ ndad In Item 18a <br />MI7), <br />7. ..Da1,• f •� I t 1 1 _�/ S_ r � J I ... 1 ' .I �� "_ .•�•r���.- - •r , I I I I I / "/ <br />