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Sent by RAMOS ENVIRONMENTAL SERVICES 9163719312, 08/20/02 11 13, JetFaX #159,Page 3/5 <br /> lof Callfarnlo—EnvlfanmMiak ProlaUron Aponcy <br /> III, <br /> Appro+ad OMB No 7050-0039(Enprro 9 30 991 See Instwructlons on back of a a 6 <br /> se print or typo Form dere nod for use on ebhr 12 If Deparsmenl of Taxis Substances(.antral <br /> Q ( pgclrt fypewrrtlrt <br /> Soceamenro Colslorn,o <br /> UNIFORM HAZARDOUS 1 Genoralor s US EFA ID No ManiFerl pocument No 2 Poo I In 6manort rn Ihd shaded area. <br /> WASTE MANIFEST` . r``� I `` , Q nae reyu,rod by Fiderol Fav <br /> � <br /> l `r&f6 <br /> Number <br /> f21854241 <br /> }p -KIau14tF �(�i i..'=S' 'CKT ,eft�' '�p+�-Ry' ��+�+�'(�� gam, Sro1a G f *ID <br /> # �'' 7 rv. 1 'r 14rke�e IW&SSON r . air <br /> 4 GenerrnoirPh ' '7t"�`F! .r i �'�.,i r <br /> CV 5 Tronsporlar I Company Nama 6 US EPA 10 Nueb.r L C Stale Tronsponors 1D IA.s.rvad �� <br /> w <br /> _ <br /> iL t ORI <br /> • <br /> J �- IE. T II ai r (w7. r ' <br /> 7 Ironrporrer 2 Campony Nama 8 US EPA 10 Numbor E Sion,Tionspoder s ID Lkesomed 3 <br /> J <br /> F eram.parlaliLPfsOno Dom no no Fat t Name on S ddrrah 10 US EPA!D Nambsr G sloto act r s ID <br /> rce <br /> a 3 <br /> ctr di-��,++a3trY`r1 s rY.lis1� 13 Fca7 ,/r+; rsic <br /> + <br /> ; <br /> I f US DOT Des�npnpn trn�lu�Ag Propel Shipping Name Hnzord Class and ID Number] 12 Co Folmar I� Total 1 A Unrr <br /> No Type OuoMrry wi/vat I Waste Number <br /> 7+.i- r� <br /> 31a1e ..tK.._. <br /> _ a_Aay.i <br /> X11 .rte . -4,Av w a 4"i L4 <br /> is t u+,sm. w,ki-de �Kr...a.�..h .. ��L}.� EPA/Other <br /> r it w .y -4-, r+- ., r n v..y.. <br /> N - r Stare a <br /> n F <br /> R EPA/Ocher <br /> A O Stale <br /> R EFA/Oher <br /> d _1J— ! — <br /> Start <br /> � EPA/Othdr <br /> K Hondting Codes r Waflea Listed Above <br /> J4.' O/ Gid + p e aks. 6 r -- q b <br /> d I <br /> ii,� S I �Irn Fn Ir Sl p^t naff 9 i l In pr Qo <br /> 1 41 <br /> ��� yrF o41�IrL+sf7'K�,�y�rl.JBr.cta_ s I <br /> rF�,t��irf, � rryi6...-rf'��Y.3C-/jy(��'FL+.� �.'61.r..�r���{.��.iLC�..r.. ...J�.y1yWi'v Trc.��s�eH..�`-t e►t,�et,.y r r��.�q..�.�v�y 1 <br /> }r'1�X1/�...Z(I ti�i^`lei R".1• Rr�4 *1w 1 11'iS W4{a47 far,._- rt_vJiJ,r .i�•,1 `" <br /> >r w <br /> 16 GENERATOk S CEp1rFI1:ATi0N I lsvrrFry ducfar.thol rhe conrenta of rhea Conspnen.nl ore Fully,and accurarel described abo+e by proper,shipprn9 name and uro elauifred packed <br /> marked and lo6ded and are m all respect m proper conelmoo For tronspon 4y h.9I wny according la applicobla mlorntrhanal and not I., govesnmene reguleaem <br /> If I am a farge quann Py g.neralor I corhfy that i have a proilrom in place to reduce the volume and raxtoty,of v.ost.gonormrd to rhe degr.d I hove determined to be economlcgFly <br /> pr044c461e and thor I how, viacsad the prachcoblu method of treatment storopo. or dupowl eurrdnrly amdobla ea me which minimius the prosonl mild fvlurr throat to human health <br /> and she enwronrrrenr OR 111 am o small gmonny generator I have made a good 61h elfors to mrmmrse my world generation and salon the best waste managomont molhod shot n <br /> ovodobiv to ma and ilial I can afford <br /> Printed/typed Nom., Srgnatu Month - Doy Y. <br /> OJA <br /> T 17 Trons ter 1 Ackna-Il,da nrersr of Recur of Mat, <br /> y <br /> R _ <br /> Prtntid/ryped Name ,gnatur° Month Day Yeas <br /> S 01 R ,, �j <br /> IF <br /> R18 Irons rrcr 2 Acknovled maul aF Recot 1 of Mose oh - <br /> T Prrnmd/Typed NameS.g re - Month Doy Year <br /> E <br /> 19 Discrepancy indreonon Space <br /> F r <br /> A <br /> C <br /> I <br /> L <br /> I 20 owner or Q orator Cerrdreat on of r.ar t of haxordarrs maretrsals cove. ri 9 man(ase ucepl Q.noted,n Item 19 <br /> T Per a y d lJpme Sr nature - <br /> Y � Montb� pay Year <br /> DO NOT WRITE BELOW THIS LJNE <br /> IC 8022A I V991 L,, IIS r , I e vl rl Wlll Illu I l ,� <br /> PA 6700-72 <br />