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APR.12.200 9:29AM ® KAISER 5XIL.IT`f 5 �=' N0.099 P.5i7 � <br /> 0411.2/22. b�'�t rr"�fa rtment of rogrcSuL�yroacaa, <br /> .a,e di�W„uaa ua—egvaranMrrnrgr rrona/anaal.warp IS s an back of pd <br /> trrm Apprr,tid OMf1 Na.2Q5q 0039 lrmi; as 9.30491 Iter.ease <br /> Cutffiarnla <br /> nose prim or ey(n F;CM AGWpod for u+o on ol;te 112•pikh!"ve, <br /> 1, GMerohr's LIS EPA ID Na. ht4niira 15aavmene No. 2. P.M.,1 !n(otMallon;n afie a Cross <br /> UNIFORM R S r- i 5 is rat/0�'ued by Federal{Cr- <br /> WASTE MANIFEST ! ! of <br /> Addr.e6L°f?s .l:+: A. Statet tkatrtutnf Nvmb+ar �y <br /> 5. GaneroPer'1 Nom+ h►ad1n9 +',�,1 ' 's C t, <br /> K.116r- i'CRlf�(a�ld�i1< - Cl,�tl�'E�:* S sto <br /> B. StalvG4neual®f <br /> d. Genorooler'a Phorm( .�`k"��1 �'-'tea"sQ•I�'•?r R'S"t'ZI= Z!�a 1a[�< <br /> 5. Tramporter 7 Company Nemo <br /> d, US EPA lD Nv r C. Stale Trowepar►o's ID jesVW I <br /> / }: a• !; a r! "' e1C, fs t D. Trvnspertera ono ! l ! 375- $1 1. <br /> 7. TPaospotter 2 Nano f!. us LPA ID Number E. sopa Tm r ID t&W-Mid-1 <br /> K i✓ }Itf C :1a:ilT::4I�'AIL r, 1 S aL� - 4 +! %' F. Tcompwwa Phonw T +"'•" <br /> 9. Motional od Fadilry Name and Slte A »» 10. U5 CPA 10 Num W. State Iwo ID <br /> ;;rCN ETi l'-fil.�fr�I{ ;W1�� •tf3�* M>►�a:. <br /> L1:9�1. ���°t' ,3. 7sQrkC+ F1, F�1q�e rhano <br /> �u1:1I "Iftr;�� �,;,K. �.a':��-;;:1 1.: �1 �3 d '� �.` 8 ... � -•�, i •;r t�£!gs •��Y1-` <br /> 1$. Coansinars i3. Totvl ts. Unet <br /> 11. US DOT Description(inoWin®prpper Sard Claw,and 1D a• <br /> hipping Nota®,Haz ' No. T ®wndtY YA/Yo1 1.w Number�., ► r I ) sit. <br /> GCLARFACK,1 1J 1` sti 1` <br /> b, rC ;4 ) stats 537/ <br /> N <br /> E a.� @'A! <br /> it EIP:tIQIO Q f? 1 1 -d D d� <br /> i Q d, O OLOtCWM1 Ftr i e. •, . !t+!s? t r 5ttle �� �t <br /> (,AL3 l_pjA d D F <br /> + r Coda For-qon Lined Abow <br /> z au 1p�� li - a b. <br /> aov ons. <br /> %1d3 <br /> i <br /> —T5. Special hlondllng IostrueNaes ved AddlHonel Mfarmatior j!r Q 3 YERA=o RETURRA 31D <br /> AVOID CMACT AND MR f•PCt'I FXT3 7E C-2-AR. <br /> WT "1=Rmcy raspo -E zwT)E 600w Id113!' ” 'o <br /> SWS:37 100 <br /> 16. 6L11tF1lATQ2'S TIF1CA110N; I hereby doclore that the cantonla aF this cons! ao FuUy and aeaur�fr deaeoiW a6mo by P'�ot ehSppT�a�*o end an elanlRnd.packed, <br /> meriord,and labeled,oad are in oil <br /> raapn�in"or condlrian For 6y 6o ep to opplieoble lnnsmalional end nolfonal®oeornman4 regolaFiana. <br /> l 161 am a terga gounNy®onomtor,l ce11 tboi 1 haw o program in plow n rod the and rogicity of waste 0onerated to the doWw I hove determined to be econorefaatBy <br /> = procdcable and khat I hqw 1aIMMd ON p1041106lo tnelhod Of treatment, or dtspowl currandp awllebie to me+.Wch minimims IM pn>r�t otasi h+roro flaroo►to h"n+an 1�11hh <br /> and the emirenreem:OR,if 1 am a rami quanply ganerafor,1 hew made o PQ fgilh wgw Io miele j=my wane pnormion and leleal the boil rano momilO nt mtlhad thel it <br /> availow to me emd That 1 eon afford. Memth <br /> 3111"a re } F � Or <br /> I R 17. Trans&~1 t of Itneolot of MONO oft ►�p dn/ Dw <br /> A hill No <br /> II {� 44 {i.`� 0@lura S,�n"Ir Yom,• <br /> 1 IVt <br /> I a1 @. Tran .r 2 A em of 6 hbmh Dov Yaw <br /> 1 Printtd Me" SipnaNro <br /> 1 E <br /> I f <br /> Dlasraponep't4adion space <br /> A <br /> G <br /> I <br /> IZo 1111 a� �'- reset oeord oterials cam b rhi t •a Horse:a e.m 14. <br /> T pt;M i/ryPw Memo <br /> Et®neNro ohanth Goy Year <br /> Y <br /> DO NOT WRITE BELOW THIS UNE. <br /> MC 90224(1/991 <br /> CPA eros--22 <br />