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• -360 2Z <br /> 9033 27420. <br /> Pleases print or (Form desi9ra3d for use on el0e(12 tch) ,writer. Form Approved,OMB No,2050.0039 <br /> UNIFORM iiAZAROtK13 'tirata 10 Number 2.Page 3.Ener�ncy Response Phone 4. (fin t rest ing1 Number <br /> WASTE MANIFEST Q 4 1 7228 <br /> 5.Generata's Name d g Address Ai,� Gerarator"s Site Address V diftent than mW ft address) <br /> HONE DEPOT CSO 3B CONPAI7 INKS DEPOT W1616 <br /> 1915 ASTON A E #111 251 CD Cg AVB <br /> Dene _ 6 C 45 219 25-2139 <br /> us.JN'1179wer <br /> 0.Transporter i Company Nana <br /> 4012 <br /> 21810 ]d OF ' Me C„�P. 3 ar <br /> 7.TmnspoAer U.S.EPA iD umbber <br /> 8.t>eagnatad Fealty Name and SEb Address US.EPA ID Number <br /> DUILIMI(aVIIDNIENTA1r, LLC. KBIT FACILITY <br /> 21245 97TH AVM SOUTH 91281767 <br /> Ptrona; , U 98132 (253} 872-8131 <br /> 9a. 9b,U.S.DOT (tn�rding Proper Shag Name,Hazard Class,f0 Number, 10.Containers 11.TOW 12,Unktftslo ,I <br /> NM and PacNnn9 f (0y}} Pm. Tye {krtfty . Wl Hol. <br /> 1.U1956 VASTX AEIDSOLS, FLAINIARbX, I'D.3, ( TL BTHTL BBTM)a RQ 2.1 BOT-BP12842 IQ(D111=111} ( 6D6 p <br /> 2.U11263 VESTS FAINT RELATED RATBIIAL 3 PGII 19(0111=%1/} 31 <br /> 00f 0j30 P <br /> RQ <br /> 3UN28i1 VASTB.TDXIC, LIQUIDS, OIGANIC, N.D.S. (2,1 D) 6.1 PGII 0116 0816 331 <br /> $ %TOXIC, IQ(0116=11) fR4, <br /> 06 7' F <br /> 4.ON3266 USTB SIVE LIQUID, HASIC, INDIGAIIC, I.0,3. (SODIUN 0112 122 <br /> Q X HIDROXI98, EOYASSION HIROXID111 8 PGII 19(D142=111) oa 24., 0010 P <br /> ,4,spa a ng ens ata � i 1C r 5` ' ?�S5 f �r s`� (X S <br /> (1) 2.1-/3 - 110(126) AWBOLS (2) 3-13 -•BIG(128) 10MLE100HPACK (3) 6.1L-/3 —MIC(153) TOXIC <br /> (L19UID3 OUT) (4) 86-14 - RC(154) ALXALIHIJCOIIOSIVE OVUM: � <br /> I <br /> 15. tdENERATotrswFBt(Nt'S CERTRCAIIDN:I hsraby declare that the cwitents Of this cOnsiW"M Bra k'and accurately descritrad above by the proper shipping nacre,eM are dassived,packaged, <br /> marked and carded,aril are in all respects In proper conddbn for transport according to appkable intamafionat OW natlonai governmenlal regulations.H export shoment and I am the Primary <br /> Fxpmler,I cart/vast the contents 01 this consfgnmeM conform to the terms of the attached EPAAcknowledgnent of CanserrU <br /> I cer*that the waste ratnimizacm statement identI ied In 40 CFR 26227(x)(If I am a large quendiy generator)or(b)(RI am a small quantity generator)is true. Month Day <br /> �� <br /> � Year <br /> . Generator'sKNferor' P�mtsd/f � N <br /> 1�.18.MternaUanal ❑Import to U.S. ❑Export ken Port of entrylexti <br /> Deb leaving U.S. <br /> Transporter signahas(fore>WW only), <br /> W 17.Ttortsportor PATrevilledgi w t of ReoW of Mamas <br /> Ttanspoter 1 PrMtedR time Signature n 1 MF.-J-1 <br /> tgh Day Year. i <br /> O t v 0.110 `.. 4 <br /> or <br /> ( Signature / MOnlh Day . Year <br /> 09 <br /> • 18.Disaeps+wy <br /> 18x.OiscrepanOY ❑Quantity ❑Type ❑Resbtre ❑Partial Rajedion Elm lte)ec9on <br /> Mardiast Reference Nurdd�r. <br /> 18b,Xtemete Fath"-(or Oeneatdx) U.S.EPA ID Number <br /> K< FaMNS Phone: Month Day YW <br /> 18a Sgnahrre of Nand ty or nerator) <br /> 19,ft Waste Report Management Method Cabs p.e.,codes for hazardous waste treatment,disposal,SW raoydb9 system) _ <br /> 1, 2. 3. 4. <br /> r 20.Designate�Fadpfownsr or CarS>icatsm receipt of hazedoue malertais rAv by the rnanlfest exdrept as noted kn gam 98a fh Saar i) <br /> store <br /> Ls , <br /> EPA Form 8700-22(Rev.H5) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQQIRED) E <br /> ) <br />