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L -0 CY) <br /> zy- — Cr <br /> Oo se 61 <br /> z , oro <br /> 437 O <br /> y <br /> s er nY $Y$Y—ql �'N Tr� ` .r1 i`'w''0 '�Ar,a. Em+namm"""va0c5Fnax ndw• OD —hz (Ns0?D <br /> IT T 2 SKS <br /> o 0 <br /> Name C D <br /> = t < <br /> C/) DesignatedF iERN �1ARBQRS ENV SVC <br /> acilly-Name <br /> Cand Sile Address user^rA nu,nna, 'i 01:1 CD <br /> EANHARJjiIRS Tx C <br /> EJIIVXI?El ii "s eaninxvmnar 008Y205 <br /> KrrtBAit."I�HwAY 7, V-NT 0+ <br /> Facility's Pfrone� 30L]—�35'401� _ SERV xCE$, 1N O <br /> U.S.EPAIp�N ��39322250 � <br /> 9a. gh, vmher <br /> uar ooroes,ip,u r f,9145 <br /> P nclu S <br /> HM 1 and Packing Group(ii anyl� ding P�'�Shipping Name,Hazard Class,In Number, � <br /> p k3175 WASTE NF.g9BY723513 v <br /> LAJ+1JMy J E LF IDIS CTINTAF to-conlaiaes <br /> �1FD Nihl6 No. a 117n1a1 2.unit <br /> LU BENZENE), 4. N'0•�, ICAS Yv ouantnq NI Na 1a wasracr,aaa O <br /> w �, V I I OL I Nr, nlq $ c <br /> r.' <br /> C7 _ r' D01 H 352 <br /> r -po <br /> ar <br /> r-r <br /> rD <br /> 3 <br /> ar <br /> rD <br /> r+ <br /> O <br /> 4.Speeial Handling Inslmcpons O <br /> arid Additional InFormalion � <br /> T 1.)sKF' H@54334! CIE3'277 CSG: 0000 <br /> 1�ERG*t�3• Ln <br /> P4H �Rg.N':Yti 00-46S-1760-•CHIsK/TFI—Corrtract retained by generator confers: a ency a-tt�ori W <br /> on initiat trans vrter to add or substitute Additional raro-s rt <br /> 15. GENERATOR'S10FFER0R`S CERTIFICATION: I hereby declare Ihat he contents of This consi nment are lull and ac urafel described above b the ro er shipping name,anti are c asshed,pec ed, <br /> 9 Y 4 Y Y P P PP g 11e'9 <br /> marked and la6eladt�lacarded,and are in all respects in proper condition for transport according to applicable lnlema[anaiand national govemmentaY regulations.if export shipment and I am the Primary Ln <br /> Exporter I certify that fie conlanls Of this consignment conform to the terms of the attached EPA Acknowledgme of Conse . <br /> 1 certify that the waste minimization statement identified in 40 CFR 262-27(a)(if 1 am a large quantity generator Da <br /> (E}IN a small quantity generator!is true- to <br /> C,aoer�loK`e7i9ffenXs Pnnia[flTppyped Name Sig a Month Day 'I <br /> Ln <br /> � 10.intematienal Shipments _. <br /> ❑Import to U.5 ❑Export from U - Port of eniglI <br /> Transporter signature(for exports only) Dale leaving U.S, < <br /> rD <br /> TrarrsporterAdviowledgment of Receipt of Materials Q- <br /> T s r 1 Printed/r !JaMonth gay `fear <br /> YPeme fd J / Signature <br /> L <br /> L6t 1 <br /> Month 4ay Yeas O <br /> Transporter_ '"ntedrTyped Name Signa ure C <br /> It <br /> tv <br /> rn <br /> ta.Dlscre�ncy . <br /> I� 00 <br /> 18a.Discrepancy ln0cahon Space <br /> Quantdy Type <br /> ❑Residue Partial Rejection L SFu!l Reie <br /> ❑ ❑ <br /> Q <br /> Q <br /> Manil Reference Number. <br /> Ln <br /> lJ.S.EPA ID Number <br /> 8b-gltemale ,lur Generator! U.S, <br /> 7 <br /> N <br /> r-r <br /> rD <br /> IaRitysPhone Q:or`:s. ❑ay -, <br /> Signature of Aliemale Fadfty(of Genemlori <br /> O CD <br /> rr Q n <br /> Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) v a <br /> 2. <br /> 3. ° �° 3 <br /> !sigtlaftad Facility Omer or Operalor Cerhficaton of ri3Dpipt of hazardous materials covered by the manifest except as noted in Ilem 18a �J <br /> TflypediVarlle Signature a, o <br /> m <br /> 100 <br /> CD <br /> 0 100-22 Rev. 12-17 Previous editions are obsolete MERAZORtS INI[ <br /> 793 /16 9 <br />