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<br /> 0''B No.2f;50-0�
<br /> 2. 22-,e�cc,-,-,,--es- Manifest Track'ng Number
<br /> UNIFORM HAZARDCUIS 4.
<br /> WAS-ENIANIFEST
<br /> .11 013120860 FLE
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<br /> EPA N-i-ber
<br /> S.COT ,*-,-�� Name,�Ia7ard C,as5.'D Ilium e�
<br /> -clal 12.U:, 3. ,Vas�@ Cedes
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<br /> I CENEWORISK)FFEROR'S CERTFCAT ION: 1 h-,reoy deccla!e�,h2t'j-e cotilents of this consignment are fully and ac-urale!y desoot'-d abo,,e by er shi.ppng narne,at are c!assified.packaged.
<br /> --nd a-.14 arrl!n a!respect In proper cc..-d-knffor transper according o)app'icable;nlerr,2-;tior.,31aid naon
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<br /> eglatcrs.Ifexport sN,prinentand i am,the Pnmary
<br /> xp c,e ca t 's)f th;S 7,8;r:.1 M 0 40 r. to the terms of ane arched EPA
<br /> CS71irl thOt Zoe N@Sta or, �R 26).27W(if a large qLw=)q
<br /> �3�erne�! �emi�ed f (ifl am a sm�fpiar,',Ity Jenerat-r);q,�,,
<br /> 9
<br /> VOffwV.!;PpLadffyped N ane- Signat,Lre T Nllonih Day Year
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<br /> -j Stuprnents ❑ -- :t
<br /> im-ort�o,J's. Excort
<br /> Polo'era.,yiex
<br /> Zarsporter s nawre{tar
<br /> Daile U.S,
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<br /> Cans! Prols�:-�rjL��',�a- c gnature Month Day, Year
<br /> 0 i. I ,I .-_,r -. 11 /,' f I'
<br /> -ansPor-ler int,ed ,red Nave i'vIlonth, Day year
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<br /> t 1S.Digprepanry ''
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<br /> ;due Panlal Re;ec*Mn
<br /> Re5Fuil Rciection
<br /> Manifest Reference Number:
<br /> 'e, U.S.EPA D N u rn b e
<br /> Fa Ph,
<br /> 41 ly Fa_
<br /> Si--afur-o"A"erna,q Fac lits tor Ge,1,&1-%1;1,, Mnritn Day Year
<br /> 19.Hlaza,doius`Haste Repoa Haragwent Mathod Cones".e..cedes for hazardous:waste treatment,disposal,and recying systems)
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<br /> 20L Dcstg.nated FandkV0 Operata:Certificatorlof reodpt o'hazardous rnaterials covered by the manifest eyrppt as noted in Item IM
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<br /> signaturaj Month Day Year
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<br /> EPA FoTi 8 100-22(Rev,. 2-417) Frevlcjs ad;tions are obsolete. A F516NATED FACIL11't TO EPA's e-MANIFEST SYSTEM
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