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voQ,��Sr,rf Arkansas Department of Environmental Quality <br /> Hazardous Wasteion <br /> P.O. Box 8913, Litt*I ( <br /> ck,AR 72219-8913 <br /> d•� Telephone: (501) 682-0833 <br /> Please print or type. (Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator's US EPA ID No. Manifest 2.Page 1 Information in the shaded areas is not <br /> Document No. required by Federal law. <br /> WASTE MANIFEST Iq 4 q q 7 1 q j S 9 0 $'Z I to 114 of <br /> 3.Generator's Name and Mailing Address <br /> INTERLAKE MATERIAL.HANDLING INC <br /> 1029 S.SACRAMENTO STREET { P I <br /> i }3 kat4Rl 1 i 190 <br /> LODI CA 9.d+ 40 t..r <br /> 4.Generator's Phone XP 333-3= <br /> 5.Transporter 1 Company Name 8. US EPA ID Number <br /> EWRONMENTAL RECOYMY MR'J. 0 0 0 0 9 7 0 3 9 <br /> 7.Transporter 2 Company Name 8. US EPA ID Numberta71r� <br /> MAUMEE EXPRESS ' <br /> N J D 9 8 6 6 0 7 3 8 RAI <br /> 9.Designated Facility Name and Site Address 10. US EPA ID Number G 5tata.FacNi[y?s(fid <br /> RINECO <br /> �vv r ; <br /> 1007 VULCAN ROAD-HASKELL 7K u i ttbntr � <br /> BENTON AR 72015 A R D 9 0 1 0 s <br /> 12.Containers^ y13. 14. <br /> 11.US DOT Description(Including Proper Shipping Name,Hazard Class and ID Number) Total <br /> Unit <br /> No. Type Quantity wwol ' <br /> A a. WASTE FLAMMABLE LIQUIDS,N.O.S.,3,UN4 ,P98(ACETONE) <br /> N <br /> E <br /> A WASTE METHYL ACETATE,3,t X1231, PGII <br /> T <br /> O <br /> R 0 <br /> C. • .��. : <br /> d <br /> ro <br /> J.Add' rr�iatenats Listed Above <br /> R,7tif., x, aa4 ` < � <br /> 'meq. <br /> ''14A A ETQNC971L tT.0 111 <br /> If RCI BIEBCCI e T DF kBtEYtKI`tIJ 61Y@ B�f1C < y � - �: - «— .. <br /> ` a <br /> 15.Special Handling Instructions and Additional Information <br /> BILL TO ENVIRONMENTAL RECOVERY SERVICES i* <br /> USE PROPER SAFETY EQUIPMENT **ERS W.Q.#3Q15**LK <br /> 16. <br /> GENERATOR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> packaged,marked,and labeled/placarded,and are in all respects in proper condition for transport by highway according to applicable international and national government <br /> regulations and Arkansas state regulations. <br /> If I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human <br /> health and the environment;OR,if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management <br /> method that is available to me and that I can afford. <br /> Prinfqdrryped Name Signature Month Day Year <br /> ���-� ® 6 <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> A Printed/Typed Name Sign ure Month Day Year <br /> S La C d Z- <br /> ® d <br /> P <br /> O 18.Transporter 2 Acknowledgement of Receipt of Materials <br /> R Printedrryped Name Sig re Month Day Year <br /> .6,,g,, <br /> 19.Discrepancy indication Space <br /> L <br /> 1 <br /> T 20.Facility Owner or Operator:Certification of receipt of hazardous materials covered by this manifest excep as noted' e <br /> Y Printy Name Signature Month Day Year <br /> EPA Form 87 (Rev.9-88)Previous editiog4s obsolete. <br /> NOTICE:THE ORIGINAL AND NOT LESS THAN TWO(2)COPIES MUST MOVE WITHTHE HAZARDOUS ST HIPMENT.ONCE DELIVERED,THE TREATMENT/ <br />