Laserfiche WebLink
893549 80332 <br /> Form Approved,0MI3 No.21150.0039 <br /> I'jease print oriy5iy(Form designed for use on elite(12 pitch]typewriter.) Emergency Respoasa Ptwne 4,Mankfest Tracking <br /> Number <br /> Generator ID Number _ 6 00502856 <br /> 7 JA <br /> i UNIFORM HAZARDOUS _ <br /> WASTE MANIFEST (' ��Generator's Slie Address QI different than mailing address! <br /> U.Generator's Name and Mauing Address <br /> HOME Datum �xD1De6 <br /> HOME DEPOT CSO 3E COMPANY 250 COMMERCE Avg <br /> 1905 ASTON AVENUE 1100arRrti �a a5�a� l�avlg255 91 I4----- <br /> f.;anerat lY4 (' 92A8A 1s Yx r !- a — — __. " ''_r. U.S.EPA 0 Number <br /> 6,Transporter t Can part'zl r ne � � .El iu Num '�3-StgM �E21�}2q � U5 FPAiQ)Numi�er7 Transpn tgr 2 CJAdr'y Na:ne I J/ llc� <br /> lU Number <br /> D Uesgneled Facility Name ano Sde Address <br /> BURLINGTON ENVIRONMENTAL, LLC. KENT FACILITY <br /> ( 20245 PITH AVENUE SOUTH _ { M <br /> FadCysPhw,e: KENT, HA 9&032 (9531 9'12-8030 -_•----- -- <br /> hia+ Hazard Class,IO Nt,rnber, 10.Containers 11.Total 12.Unit !3.VJasla(:cdes <br /> q<, 1 ,la r:5 DC'''Uesc�^tion(inGad4k;Prc:Aer S. ,.ping Name, No type Quantity WtNal' <br /> F,n ( n;iPaci m-�tGrorp!•aryjj D001 Dfl35 0331 <br /> UN1950 +aAS1'E AEROSOLS, FLAMMABLE, N,U,S. (METRYL ETHYL KETONE) - <br /> Vc 0a oo (cl 1 <br /> � � 2,1 DOT-SP1284'2 RQ(6001=100) <br /> a 0001. D035 331 <br /> �r2ijN1263 WASTE PAINT aELATED MATERIAL 3 PGII DQ(D001=10fl) <br /> \ OC(� D006 D016 331 <br /> UN 2810 MASTS TOXIC, LIQUIDS, ORGANIC, NaO.S, (2,4-0) 6.1 PGII (�0 l B' <br /> X °TOXIC° RQ(DO06=101 <br /> 4_ D002 122 <br /> CDd3266 WASTE CORROSIVE LIQUID, BASIC, INORGANIC, N.O.S. (SODIUM p <br /> X HYDROXIDE, POTASSIUM HYDROXIDE) 8 PGII RQ(0002=100) 60 0 <br /> .4.wpeti�al ha.wli::g instrucikns ar,d Adiiilrunal!ntgnnatign ( <br /> HOME2,1-03 - ERG(126) AEROSOLS (2) HOME3-03 - ERG(128) FLAMMABLE LOOSEPACK (3) }IOMa6a1L-03 - ERG(153} TOXIC <br /> ( (LIQUIDS ONLY) (4) HOMEBB-04 - ERG(1541 ALKALINE/CORROSIVE LPROPOSALf! <br /> and proper f5. vENER� ATOk'SIOFFEROR'S CERTIFICATIION: <br /> I hereby III dparacondl that <br /> n for fronspoof aecord ng9orsappilcah;s ntemal eaa Andy aCbnei 9ovammanlal egu{slions ing lailiti, <br /> Ifthep6 Fort shin r oni1ard f am he Pp many <br /> marked and Iabetediptacarded,and are A <br /> 1 Ez„it e'..I cctity brat iho contents of ihis cufslynmen(co,,fenn to the terms of <br /> tf�am!lacried a large quantity generatto)or(o)(61 amla small qusntiiy generator)is Irue. <br /> t ceriiiy hat the wasie minimization statement identified in 40 CFR 262.2.(a)(i Y Month Day Ysar <br /> Signature <br /> GeneratofsifYfarols Prntad ypad N�vne '^' _ <br /> '17 t� ...._ <br /> S. Pon:of enlrylexi <br /> -- <br /> 16.tnteroa!cnal Sftipr?enls f l impon to U.S. J <br /> Export frwn U. <br /> Oats!saving U.S.: _ <br /> Transporter signature(fa Exports or'IA <br /> F 1M�nDay Year <br /> Sirurs <br /> r( n <br /> Transoo:tar 1�F'rn'•ed)tYpsd Name <br /> �0oil <br /> a 5lgnalirre 4?r <br /> n <br /> z,Trans iter'/Prntedr?yp g name �, ,•n^ �^ p� <br /> I- <br /> 18. ._.�_------ r--1 <br /> �-1 Residae i Partial Rajeclion Eli Full Rejection <br /> 5a.Uis.repancy indiration Space Quantity Type <br /> Manifest Releranca <br /> U.S.EPP•!U Number <br /> ,8b,Aiiernala Facility igr Genaralcq <br /> Facililv's?none: }Ahontl <br /> t Fc.Slgnaturaatura of A.Itarna!e`at•°dAy for Generator) <br /> i <br /> 9 19.Narart ou�^^ s N as!r ReAo!i fda»aga'.ient Ma!hod Codas(i.e.,codes for hazrdous waste t saUnent,disposal,and racyc!ing systems) t <br /> 3. <br /> LU I. <br /> Month Day j <br /> y0.Oesigaated Facility Ormer or Operstw:Certihcatign of recoipi of hazardous materials covered'oy the manifest�a <br /> e <br /> except as need in tem Year <br /> a ' <br /> PrniaclP/;:sdNams �����1 <br /> errs�s �c�n�%1 <br /> ION STATE(IF REQUIRED) <br /> Form 8700-22(Rev 3.05) Previous editions are obsolete. p�S1CiNATED Fr�C4LlTY Tt7 DiwSTINA� <br /> 5'3`23 <br /> ADV ? -m 5v.a <br />