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<br /> 00 218 SKS
<br /> please r E f e. Form Approwd,OMB No,20E0-00S
<br /> ;WASTE
<br /> i K AUS ' Generator ID Nafaee a 2.Pe, �S f ms r Pa ncc r Ppa„a,� 4 Manifest Tracking j Number
<br /> 006952186
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<br /> Generatow's phone: -3Pt
<br /> U,S,EPA ID Number
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<br /> 8 C'S.Gnafed Facility Name and Site 'arcs � EPAn U.S. 0 N=ber
<br /> 9T DOT t1 rtauon€rFa gins})hepar Shipp';r,Name a „kms:C van; .rnntatin , 1Z n, ?ya
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<br /> 15, GENERA OR`SlOFFEROWS CERTIR A`IOW i hereby deJvTs,that cw!ante of f3��s rnn.R; �r arx,f.,ly aar �cr3 �zg e_rnne d'above bythe prow shippm narne,and zee�a ,41a d. aged
<br /> s*sdA,d aee' 1ptn r sd:and ar in ali resects 3n prone(' undilion for,ransport occord+na c:,"l F..<�e•r,t.,naJJwn a and nnr&, Ec.urnmen al regulations labors 9 ox"M ft-meat amid?am dme P li mary
<br /> Cniorier,i cprTlyffiatflze cantems of INS comqnrpent ccnfrtrrt to the rims ct the at;acrted EFTA kKnw0edom-n€of Consent,
<br /> i efy ibat wane nur¢irrr.za?rcn s%�terne,<B;iBi3€nkiFeU In�E CrR ati2.�7{aa,it P am a arpe ;uarnd'y uereraiorl er�f€if°em e Amar.r�_;�n:lty�anar;s€cr}fs t;sre.
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<br /> C ZaLarGrCfa aT �U dame SSran Month Cay Yea,
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<br /> Tran, <)rtersgnre re ex arts Orly?r
<br /> �R m,r Cyte teaurr��::.
<br /> f7,7r t ix"i8 ixr t h.; t of Receipt of klate6ajs
<br /> kl— Tr M n T ane S xnat e Month Crg Y
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<br /> ifs akure unit Day Year
<br /> `:3a,tl€ -mar t wort assaace r
<br /> �� Cua city Typo, _ ❑Re idlz-« ( Partial Rejection El RAI Reed*n
<br /> Manifeat Referenw Nr:rnbsr:
<br /> Iub,Ansa ,..e r3:,t4y Sar Svt`�t-rSC� U.S,;ePi 10 htuk733tsser
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<br /> phone:
<br /> LU Signature of Altrxrnate Fa: h:(;rr Gene:torj Nfc t Cay ;sr
<br /> 7ji _ ,Na_�rdcas>'yas a fkeperi rAarea en enf e=had Cra, F .,ragas for haaardeus xas€e t eaame f,lisp,:.sail and recyr ing Sys€ems}
<br /> ?i3.Bas.g ratev E.=r-sE P C a er Cpe: C riff [ n c€rec2iPP o`t azarLuus rr tana(s r seed by€he rnan feai except as,nota i m Ife n 1 8a
<br /> F rime 1,i ye d Nape ivao tre
<br /> EPA F� tdr £-2 A� 1 ? e�,�� a c�reod�sciate. DESIGNATED FACILITY S« � SY
<br /> `37117 � ,
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