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OOt 07-04 04:19pm From-Asbury EnvjgQK Dixon Customer Service 17076782297 T-276 P.004/005 F-189 <br /> A <br /> F <br /> NON-HAZARDOUS WASTE MANIFElf <br /> (Ferro doelpnad�use on 61110(12 Iloh . !ti fJlaftllstd 2.Pape 1 <br /> Pkeee 1.®onermea us EPA ID No. Document No. { Q of <br /> WASTE MANIFESTR ♦ �7 <br /> 3.0 re N&MO and Melt® w <br /> yN• <br /> Gottagilke <br /> 4.04 of• N( D ` a US EPA ID Number A.state TransconI ID <br /> 5.Transporter 1 CAmpemf Norse C A� , ® B.Transporter 1 Phone <br /> ® wwA a u9 EPA ID Number C.state Transpottlit's ID <br /> T.7roroponer 2 Company Name D.Transponf 2 Phone <br /> @.DealWmMd F40111I Nance and Slls Address t0. US EPA ID Number E SWe FOolary B 10 <br /> fi~ L.A'Arwit.6 t > 'R.an+DaKM L F.Factilip Phone <br /> %O ^�Z NA 1pw* i; WAA_. <br /> lie, <br /> nSD A' J Y � sZ 12. Cote. ,.0011114— <br /> 11.WASTE DESCIRIPIION Ido. Type OuorMi1�N VY V%. <br /> r <br /> G b. <br /> A a <br /> A <br /> T <br /> R tl. <br /> W <br /> H.HOfldang Codon►or Waot6s Usted Ave <br /> O Additional sipuditijong for Matelots III Above <br /> O <br /> 16 8p•dal HandPn@ trt•a tads and Addtgonal InformationWile 199 <br /> =►,�t4 (1y tOfIA� %(,�►�r►Y7 <br /> 2 � � y�e►V �®t�.e® ®y��Y1Gv� a c.n 4yl®S �„�� <br /> p . AMCOASI <br /> AWAV F_ <br /> ppTDq•S GER VICATION:t he eanly that the contents of m1,shipment re m tedwal ccurjnutom cased rootN�orArld—ra as rasp"" <br /> In proper condition for 1ran0twn.The matarfete desoribed on Ihle MaeWea aro nd subject <br /> Date <br /> 9lgrreture f• ,,r' <br /> Month pay i Year <br /> printedrryp�Nam® IF IF, <br /> "" r^ !.• .K r} _ Dole <br /> TFl 17.YMD*6ner t AdmoMedgement of RecelPt of Wallets el{ptature Month DAY Year <br /> p PA yped Natrta _ !` <br /> sC t?( Date <br /> O 1@.Tranapoper 2 Acknowledgement of AGOAPI of Materials <br /> Slgn®lure Month Day Year <br /> H pdmed/ryped Name <br /> T <br /> E <br /> R <br /> ,@.Dlseraparwy Indication Splice <br /> F <br /> A <br /> 2o.Facey Owner or Operelor;Cordhc®tton of too6lPt of rho waele malonaia covered DY tato manliest,except an noted M hem,8. Data <br /> 1Signature �® Yf� <br /> TaPAntedtlYPeG Name <br /> Y �. <br />