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C- -0 CY) — <br /> > = — <br /> Cl) 0 N) <br /> , se <br /> 0 N) <br /> 0 M <br /> N) <br /> > <br /> > 1`41a$B 0-11 nW(F—des d r0r nSB On Bills1-jr., <br /> UNIFORM 14AZARDeq <br /> ea.- WASTE MANFFFST <br /> M Usk 0 <br /> Paarass <br /> V > <br /> < <br /> W <br /> CD <br /> J 6 FFA IA m—", <br /> U.S EPA IO NumFmr <br /> 3 n.."W F#fin%., <br /> :.41 FIL-Lill <br /> )CKAMP. <br /> F,- );ptone <br /> 9. Ph U F COT to ply.: rjl,u Proper lhippi,q M—Hn-ein 01...10 14—be, <br /> 3r 0,if, <br /> 0 <br /> 11 S-aa;Ha.dng <I%cj:orrs arri Ad6w-J W-86- <br /> .5 GENERATOR SiQFFEROR'S CERTIFICATION:I hereby declare that the wriont;of[his consignment are fulty and accurately de—bed Bii—py th,PfOptr$hLrrpLnq name,aid we classified packaged, 71 <br /> marked and and are in alE respects In proper Gand1liop for transport according to applicable kirlemaijunisland national governmental regulations.It exporksh6limutand I am the Firmaly <br /> portez i rertrfy that ly.-ftents Of this cxns�g—erl w.fo-10 the terms of the attached EPAAcknowledgmenk of GOMM <br /> lcertify Thal the waste minmizatbri statement i(Jel6fiierli in 40 CFR 262,27(a)(it I am a large quantity generator}or <br /> dr)(IN am a sma;[quantity generator)is true. <br /> Month Day Year <br /> -a 'r, Import to U.S. ❑Export from U.S. Port�f entrrfe%il <br /> -is <br /> L <br /> Trawrisparw sgi-kaluee(for e4iitri5 only). Date II 11.5-. <br /> w17 Tme"A"p,10, <br /> t of Rwjpl of Materials <br /> 0:. Transporler I PMNameYW Nae Signature t4onih Day Year <br /> A ��T r-c-' <br /> I UL L H 1:1,h I-1, Year <br /> ZI T=2 PMbpdTypd Name Sign;:If- <br /> I1B tTisveparuy /^ <br /> 18a Die WWicy indication Space E]Quantity ❑Type ❑Residue Ll Pahiial Rejection ❑FW Rejecvn <br /> KA,nilasq R.1--NtIrlber. <br /> 186 Alternate Facility w Generator) US EPA IDNumber <br /> FacikWs Phoine� Alonth zay yeal <br /> W Sovoc of Aterrote Facility(of Gerieralor) <br /> z <br /> 0 <br /> r, 19 Hazwdipus wasle Repel Management Method Codes(I e.codes for hazardous lHasip treatment.disposal,and recycling systems) <br /> 2 <br /> 0 <br /> DNOMW <br /> Faddy or OpwW Cerbilicallion of tempt of hazardous matenals;covered by 1110 Manliest OxMPI as n'+,1 in ftelk"18 Month Day Ytx C) <br /> GENERATOR <br /> OESIGNATED FACUTY TO <br /> ajibuns are obsc4ete. -u <br /> 11 0 <br /> Cl) <br /> M 00 <br /> 0 <br /> 00 <br /> 0 <br />