Laserfiche WebLink
Pleass pn, ;# <br /> Form Approved.OMB Na,2050-0039 . <br /> UNIFORM NAZARQOUS 1.Gene;ator ID Number 2,Page 1 of I Emergency Response Phone 4,Manifest Tracklng Number I' <br /> WA5TE MANIFEST C ( C3 0 0 19-4 10 7 <br /> 5.Generator's Name and Mailing Address _., $OO 424"93GO 0 ' JJ� <br /> PIP BOYS 40562 Genefolor's SlleAddress(if diffarenl[ban mailing address) <br /> 1DI F ORONARD STREP <br /> HAMJN <br /> Generalots Phone:hone: 200 3616-(}1jS <br /> NJ 080,37 1401 SOLl"N OHEROKEE'LANF <br /> 6.Transpoder 1 Cl Nama LORI C a DC7 �I <br /> WORLD OIL ENVI�C3(VMENTAL Sfill WS. <br /> />'PA1DNumber <br /> 7, <br /> IN qns derPCompanyName <br /> ti/.AD'O28277036 � <br /> !'C' LfDWIDE RICOVIl SYSTEM INC, U.S.EPA ID Number 3 I' <br /> t;.Designated Faclllly Name and Sila Address C.A R 0 Q(} 7 tj dj22' <br /> YES MANAGEMENT, INC. U.S.EPAID Number <br /> I US HIGHWAY 915 <br /> YUMA <br /> AZ <br /> 13"365 <br /> Faclli#y's Phone; A Z IRO 0 O 5 2.1 1¢45 <br /> 9a. <br /> 9b.U.S.DOT gesodpiian{indiuding Proper Shipping Na <br /> mm Hazard ClassID Numbe . <br /> HM andPack9ng Group(if any)} , r, 10.Containers it,Total 17.Unit ' <br /> 0 1'YE�fd l?L'r?A NA DOI IS%'l�57E,SOLID(BRAKE LATH �HAVI;��sj No. Type 4uanlily Wt.Nol. <br /> 13.WasteCatlas 'i <br /> 3. "s <br /> ..5 <br /> it <br /> 4- <br /> '17 <br /> r� <br /> i <br /> 14.Spec€al Handling Instructions andAdditianal Iniomratian u <br /> • Il <br /> EMERGENCY CONTACT:CFfEM REC 1-800-424-9300 WOES TERMINAL,CEk�E s CS �P�2�IFILI;�9131:�61f3231V�t�PIni�34�. „ <br /> BRAKE LAi HE SHAVINGS * � <br /> �O� ORI � I?I� EQUIP <br /> (��0 l �'- !f _ <br /> 15. GENERATOR'S1oFFEROR'S CERTIFIC TION;t herebp declare that the contents of this consignment are fully and accuralety desedbed above by 16e proper shippingnam rdare { <br /> marked and labeledlplacarded,and are In all respects m prop condition for Iranspod according to applicable Inletnallonatand national governmental iegulatlons,ff export shipment and I am fhe Pdma <br /> Exporter,I certify that the contenls of this consignment conform 10 fhe terms of the attached EPAAcknowtedgmenE of consent. d ssrtled,pacl� ged, <br /> t certify€hat fhe waste minimiz VOP statement Identified in 40 Cl 262.127(a)if f am a late uanil ry <br /> (}( 9 q ty genera(or)or{6};ill m a small anG <br /> Generalor'sl0fferor's Pdnledfiyped me ,� qU ty generator)IS[we, ' <br /> Signal Moal Day Yoar l <br /> tfi,fnlernat€oval Shlpmonfs / .. � =. <br /> import to U.S. ,. LlW, v <br /> Transporter signalure(for exports only): Expprt from U.S,� Port of enlrylexit: d <br /> 17.TfansporlerAcknovrfedgment ofReceipt ofmal Date ill U.S.: <br /> Transporter 1 Pdniod/Tyful Name <br /> p� Sfg store <br /> ,f JJ ggt �� // ,,,�` Day, Year <br /> 1� ��Ci,�! f 1' €' i r„ � Month Da } e <br /> r�'ti <br /> f?an oste[nntidffpped-Nal _ lgnal f) K <br /> Month Day. Year 4 <br /> C 7 s <br /> • ,( <br /> Sa is�rdpancyfndlealSpace ❑ quanti�� / J <br /> ❑Type r� <br /> Lf Resi ue- Partial Reeclion Q Full Rejection ) I <br /> . .i <br /> lb.AI#ernate Facllfly(or(ienereler) Manite-t Reference Numbol; <br /> U.S.EPA ID Nu or <br /> xillly's Phone, <br /> c.Signature of Allernale Faeflfty(or Generator) <br /> Monih Day' :' Year, h <br /> 'k <br /> Hazardous Waste Report Management Method Codes(f.e.,codes for hazardous waste Irealmenl,disposal,and recycling sys#gms) ; <br /> 2. 3 <br /> 4. <br /> t)eslgnaiad Facility Ovmeror Operator:Corriaca'an of receipt of hazardous materials covered by the manifest except as nded in Item 18a <br /> tedffyped Name ;3 <br /> S€gnature . Month Day Year. <br /> Ti 8700-22(Rev,. 2-97} Previous editions are a6snlele, - �I/ "� 01 � "T <br /> DESIGNATEI3I AGILITY?t)(�ENE��f3R <br />