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; <br /> j <br /> l. w t <br /> P <br /> . .. <br /> 9. <br /> EORD <br /> ow <br /> w <br /> 3 7►TK ttltMiL <br /> fMKN A R •; <br /> PAMMg Or WASTI (Matt bo filled bT`prodbcer <br /> = " aUl.. &VA3TE M'at be filled by h ) <br /> �aulor <br /> {fes a: <br /> t *ggtaf4tesa'adZres®s cLl * <br /> esStY <br /> 5 ', ism <br /> Numbe Tim <br /> Mat uptreat ty r• <br /> P.o. or Contract N.• SOIItA�one Nuahar, � c'ate. <br /> Yalapbow geasbete <br /> Dstar dfr•// -.,7� Sts;a LiquiQ pasta Ha'::cr'c Fa g:strati:-� <br /> adat plated ig: _ _,, _ <br /> sSob No.: `c. <br /> QLA <br /> Taps of Prac"a A > i. *.s• <br /> .rich ! 1lastes:4 ,el fftl Qril 8ng -Code. �tTiels:; wacu� c:_ pa . <br /> Ezamp at sista Plat n6, aq ^ 3 sa <br /> . /a The desctiliad caste ',as baule' _y -e +r r' n :eros <br /> nsatcwetez treatment, picklity'batli tsol ceiinft�7 batt.. end vz+, <br /> DESCRIPTION OF WASTE Must be filled by producer) ,•e,.ify Ir,r r� ie- .`. • <br /> of perjury that .he _'O:ee:,i.•3 i e <br /> Cbac4 topR of Meares-. 1. fl AL-_" a tt be ! .t. ao3lne>t so cc;rrect, - ti <br /> 3 "U <br /> _ 9' t. 3r: <br /> 2. p,� n lbw a +$e+`• M'a' _ G;: <br /> �r "lestict a <br /> >u <br /> �srz • <br /> 4. ►,,,j Paint *'.,A se lf.' 4taier, vsats (grin: x 3r di <br /> 11. e o <br /> 3. C) �lveac . . <br /> d,'Q retraot,.yi lead sludge 13. 23 to <br /> Chea: ai tali!: wastes, 14. pto$,..,r�•a •.at.r <br /> s f 15 fl zw' 1'!!4 s-de lest zwi L As - - a <br /> to Eg <br /> - 1€0609ate S_a•.a <br /> 1t slatcce-ptac� <br /> j Heap <br /> 'tea.-_ rG�`"°=>'•" -- - " <br /> phenolics, Solvents (!tat), taia (fiat), t <br /> 'rssrl-s Met), c7aniAe) ' 1 r-covtry <br /> :;� a .•, iappef#yt es, •>: „rnl:rst'i + ors tette tivu-r-ate 3to. <br /> 2 � � � Q1ipoM1 tsp <br /> It weals is geld for d:aQrsal sits -• ' rffi - - <br /> illDisposal Date: �Y- <br /> LJ_ <br /> s. <br /> -- l.J I certify; (or cisc:a a <br /> El <br /> pt per5ury :Rat t"e :,�rcge•r+=; t <br /> 6. and corroct. <br /> pTvpertisa iisata: Esai,re` it_ .-rd to the <br /> . _a toxic f1aeaibIa corraatvs e:8 a_ti • •+ <br /> PK ...� The sits operator aha.' a.ua•- �' at r <br /> al �• Dtmila othez $Yate rtsent of Health wit�i awnthly € rtpcitt+. <br /> s s 62s. fps <br /> G°cu: cellons _ <br /> Qi:isss ate! <br /> other� <br /> ®solid n l iquid . ®dudes 00thev <br /> k <br /> yas! !Tata: aPsci y <br /> 5"Cial vownleg tostssctlors (IU 9001777 <br /> >" <br /> �. <br /> •d. <br /> sesta is aa+te$Ab" to the best of my ability and it was delivered to <br /> ta�ssdl <br /> I3fFi?illTl <br /> Wrote sts hauler (it OTMXATIXIALS,C" <br /> apps �1 <br /> (Or decltral un&tr pNlalti► <br /> 4 m_ <br /> �,jaarv.that the foregoing is true. <br /> $w,+ <br />