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Feb. 16. 2016 3:45PM GEORGE W LOWRY, INC No. 4141 P. 1�Q <br /> .. .� � '•' _ Lam' <br /> t' 'z. ,.. Form Approved,OMB W.2050-0039• <br /> Please pdrt4'sc. :.(Form designed for uses a (1R ) 2..Page t o R�pores PhOn® 4.Man' Treckift!)Nten4er <br /> t7MTS `a, i5fi3JJK <br /> WAST& EST .....•. . • . <br /> Gen a Ad�4ss s i�/v�rAap + +gaddresal <br /> Ri <br /> 19in isrlS <br /> STMKMM,r-A- <br /> Genews phone: " ID <br /> U$•EPA •Number• <br /> Tran spwIle ortper'yf ' <br /> ;. .: D N <br /> U s E➢A I umbel• <br /> ---- U.S;EPAiD NSMber <br /> a <br /> law a.X61 klr.. <br /> _ t <br /> :9a.• 91j:.S.04T ;, ;_"l1'fit4lidlix3'f'roper ...Q:q�s;lfkNUmber;•:;-: •:�:.• ..:...:....::::,.:,9Q:� 3.W�eCodes <br /> T /2.thtb <br /> augury WIA�. <br /> HM ;ow t5 ark)• Tme - <br /> )t t: ftpA.!'tPJ<,+►RM#9 WAST•S'JLft?K :Y*' - <br /> —.: <br /> t <br /> 77 <br /> 2. <br /> ENV <br /> :.•. <br /> lTO F <br /> d_ PQRTa�i�A; <br /> 14.Spedai NW tial In Pry it t itt3�•.k ' r A�w ®'S" .� <br /> ®- <br /> , <br /> ' •2F1?O <br /> 45. GENEftAQORs�lOFF.ERQFir C@RTIF(GA :1 t�eby doctors that are Is this carWpmm4 aft fulti wtd a6m(AbAf deearbed above by 0. eh p nafrre.-d are dsasiued.Raclwd• <br /> madued e� .. ", li6vdoo.and-*e IA all respects In-pmW ovAlin for fmmpotpa�a +9 6o'ap a inbem8ba1a1 md' 8carernmental f .It export shipment ark lam ItN'�+me<y <br /> . .•Exporter.I t�mry t►�4�wrests of male 1 to the term5o11h0 atlerlteif <br /> I EPAAdmouledAment OFCofnIaemnt s.,•etquemry. <br /> generaoIre,in 4Q GFR 2.27(arre <br /> ceiPry thlte »nlmizaon:e meM deruPegffiGyvaor )CMomh U111 Yew <br /> ed Nam i Sir® <br /> F 1&Innaaa�SlepfnenN <br /> C1"Eprt am <br /> u:S[ n U.S. <br /> • '.T'r. .. :'e�naNte.(roR exports ontyy;"ti.,...: .... • .. .• ...... .. . :'pati.leay(r�,u. <br /> W i7.T ", o600 <br /> •p. ® 9gnalure Mag Year <br /> Pfmte <br /> rensporter:2 dfTyp.d Name SlgnsN+re <br /> -Month-- Day �Year <br /> k. R •. ❑Farrel%.a. Full scrion <br /> 18e.Diauepancy Indicatlon Space Q Quonoly ®Type <br /> Number•: <br /> :186:AINmMe•FaaTdy(oP Getxfre�r) <br /> U.S.EPA ID Numbef <br /> Q <br /> u4.•.FQilys'Phooe Morany 'Year <br /> t � 9tdc:Sigrratare� ie pacdity(or snare or ' <br /> 19.HarBr Waste Report Management Comes 04..codes for hazardous waste b em.d I,am fecydrq syr) <br /> ".f <br /> I 20.Desgalaled PaCdlty Owner arAperator'Cert�etighfit reCelPt of hezaM4Us rt�leriais Cored by tho mel e8l except as need in Item 18a ® mo ft oily Year <br /> {1 .pdrded FiR Name' i �� ' I/� tut$ s:• - 're; ",� '/ PS%.r ` f <br /> 4 Form BIW-22(Rev.3.05) Previous editions are obsol®Ie, i RANSFO i ERS COP'S <br />