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<br />Form Aw oved . 0108 No. 2050-0039
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<br />UNIFORM HAZ ID Number
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<br />7. Trarsjxrter 2 Corniany Name US. EPA 10 Number
<br />8, Desk;tnated Fwil Name and Site. Address U S. EPA 10 Number
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<br />fly. U.S_ DOT Descuptior. (mcWng Ptopar Skipping Name. Hazard Class, 10 Number,
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<br />GENERATOR-SfOFFEROR'S CERTIFICATION: 'lea -
<br />marked and labeled1racarded, and are in all respects in proper condition for transport accord ng to apphcWiinterrationo! and'wliona! �)vprvmenof'regu�tons. if export snipment and I arnft Ptima.j,
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<br />17. Transporter Aanove.,edgment of ReceV, of Materials
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<br />Mani{ t Reference Wnber,
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<br />18+enatareo{AemateFacrGPy{arGenerat+ar3 k"Op"'n Day Year
<br />ReOon Management Method Codes (i.e_ codes for hazardous waste treabnent. d*psal, and recycling systems,
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<br />D'w-va�" Cvtifnation of rpt--ipt")f 'by w -e mw"fes"eXcep*' 8� r"01a, m'
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<br />EpAgory n 67Llj-:2-/ (,Ke%C .5-m, vrewous eunlomi ate uuwit1w, 0 r, �'A7 vvi; C65 ri. 1 -' t I I V V, M ! %e%. 't v V,
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