Laserfiche WebLink
M fA -Uop <br /> v (D = VO <br /> N <br /> -0 v <br /> v (D O N G1 <br /> TI <. CD (D <br /> O O (D Z) <br /> NCD <br /> Q � N <br /> W <br /> M CrI <br /> � � W <br /> f'Inwsn <br /> Print rnivv,°iFnrm des ned Mr Use on stile 72-pdchl ly ewntnr,) _ <br /> UNIFDRM NAZgRDDU9 ed off DN'umhnr Faun Atprwee Grab. N <br /> WASTE MANIFEST ?Papa f W )Ernargarxy Wr.i, e'+Iamhat r --- W <br /> fE .ameral 55 <br /> a amnan airing rt,aas 0083849 FLE N <br /> nnumlo a lar drv•5s r rIL1 r..�ri.._ .. <br /> GBr1 PhdmB- <br /> - ran" r inpi amP <br /> II U. FPa 1D lemyr U) <br /> f 7.Trnnsponarl Compan- ' <br /> �' + u S Era 10 rJunu,,• (n <br /> N Druignaled Farillly Name and Slle+Andress I O <br /> D q EPA ID NLIr1bN <br /> O <br /> Fariiay's Phone' <br /> no 9b.U.5.DOT Descri acking {including Proper Shipping Name,Hazard Class.ID Nber D <br /> Hki and PGroup(il any) um1o.rowainers ,. 11 1 <br /> 1 - No Type Cua^t"7 Wl.lvd 'A YJYIe=rsas <br /> J�� F <br /> I <br /> W <br /> Z <br /> W <br /> [7 <br /> 3 <br /> 4 <br /> 14.Special Handling Instmdions and Additional Information <br /> t <br /> i <br /> 15. Gark"d aTOR'SIOFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment am fully and aceurately described above by the proper <br /> f marNed and labeledlplaraNed,and are in all respe0L4 in proper condition for UanSpprt according to applicable iniemaponal and malional <br /> Exponer.I certify that the contents Ol this consignment mrifonm to the terms ofthe attached EPAAcknowledgment of Consent, Uvppatg rurrc arN ara 0. <br /> Isemfythe'lhewasiemimimaaaonstatemenlldenlMedm40CFR 26L27(alfilamala a uanG 9Ovemmentalregelatz'MatleryptshranniamirtllampyP <br /> eneralor erods fint yped Name 9 q hgeneralorl oric)(iflare a smallquantirygeneralor)is hue. <br /> � igna ora <br /> J 16.InterrI loml Shipments <br /> _ ❑Import to 11.5. ❑f <br /> Trans dersi nEven from lf.S Port of entrylev <br /> ature or ez orfs onl <br /> W T7 Transporter AcknaMetlgmenf a<Receipt of Maledais Date leavr U.S.: <br /> Transporter 1 Prinfedrlyped Name <br /> b rgnalure <br /> EL <br /> a Transporter 2 PrinledrTyped Name I <br /> � i9nawre I <br /> 18.Dlscrepanry <br /> 18a.Discrepancy IndiraliOn Space <br /> ❑Duanety ❑TY['e <br /> ❑Residue ❑Partial Refetton, <br /> .—P,a Reresaon <br /> Ior GManifest Reference Number <br /> 78n_Allemate FaafaY erteratdr} I <br /> J <br /> u.s.EPA ID Number <br /> L) <br /> � Fauh 's Phone <br /> In I8c 89rialumol Attemale Facili <br /> F [y(w Generalon <br /> d <br /> 77- <br /> LU 19 Hazardous Waste Report Management Method Codes M1 e..codes for hazardous waste treatment,disposal,and recycling systems] n <br /> IM f 2 <br /> 7, 4 C n <br /> mated FacuOperatorp y <br /> D ° <br /> dY Ovmer or r:CeNfication of recei 1 df hazardous materials severed h the manifest ezc Q- <br /> Pnnled?yped Name epi as noted m Item Be <br /> Sitlrii <br /> � Mien Y Y9er = <br /> !y <br /> cQ .?A Form 8706-22[Rev 3-05}Prev'ous edrlio s are obsolete, N <br /> CD <br /> rN GENERATOR'S INITIAL COPY CD <br /> Cil <br /> O _ W <br /> v <br /> � W <br /> N W <br /> W l <br />