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-MAY -'30-2007 03:14P FROM: <br />. °' <br />'�N�' <br />v <br />TO:4683433 P'2 <br />DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />UNIFORM HAZ ARDOuS 1. Generator ID N <br />I T <br />-Fol of <br />?i WaTWf30Bbrhon& <br />14. <br />002100984 JJK <br />5. 1100% *Awi VIVO a I W, "V Genendoft She Aftess Pf MWW than malting address) <br />- <br />11Wlt TRACY B.VD MO N. TRACY IXVD <br />CA 9M TRACY CA ow <br />6. Transporter` 1 C=pM Name U.& MID Number <br />7. Tmspoder2 Company Name U.S. FFA ID Number <br />8. Des <br />49ANT*ffiftii�ES CORP U.S. EPA ID Number <br />Facill es Mona:. (NOW7747 <br />HM <br />and Padft Group Of any)) <br />13. Waste Codes <br />NO. <br />Type <br />Qmtky <br />WLA(d. <br />OILY SOLIDS NON RCRA, HAZARDOUS WASM SOLID <br />D M <br />p <br />3. <br />GENEUMRIS10MROR'SCIERTIFICAMN: I heiabydeclara ffi8tft contents Of this MO~ am fully aW accurately described above by the proper shipping nam, am am dauftd, pacitaged, <br />marked and labaledolecarded, and am In all respects in proper condidon for transport according to applicable International and national govemmental regulations. ifexport shoment and I am the PrImery <br />EXpOrter, I cw* that the contents of this consignment conform to the terms of the aftachad EPAAdmow0ledgment of Conseft <br />I 060Y that the MO mWmhft statement Identified In 40 CFR 2VX(a) (If I am a large quw* generator) or (b) (NI am a wd quan*!!,nw%js true. <br />16. International Shipments— import to U's . Export frn U.S. Pwtofen <br />Transporter I Name Mccid Day Year <br />Month Day YAr <br />18a. Discrepancy Indication Space Quantity CITYP'. EIResidue Elpertwit*d, El Full Rqecdm <br />Mantled Rakence <br />118b. Afternate, Facility (or Generator) U.S. EPA ID Number <br />Hazardou Waste Report Management Method Codes (i.e., codes for <br />LU <br />OT T <br />20. Desirated Facility Owner or Operelon. Certification of recelpt of hazardous materials covered by the manifest except as noted In Item, 18a <br />CDA <br />07nn olo% in— <br />DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />