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#� � , Manlfes�ID <br /> + #ericycl�'pX43946 <br /> _aL <br /> 1,-75 opie" � III�I1lII� IIICIIIII�IICIIIIIIrMlill111� ____ <br /> r <br /> WASTE TRACKING DOCU1kt1 NT MAhiIFEST <br /> Tnslrucltons� <br /> curt rnr�rtte�r �aeet�ealsstac"a+tcert'zPlete <br /> 2 Pnnl�stg�,a date 5ecttotkfi <br /> 2 <br /> 3 Keel lie bel ont(blue)copy foryour <br /> 4,Segl lhrs formin the zipper bag on iii ouste oFlhe reCurn�iox - <br /> Manifest ID <br /> a ,„ m_ Generator(Haller)Cerltffcalion "� I <br /> I cerhfy� ak khts contamec has been:approved for tfie marlCng of regulated medical 14asteo sharpy wastes nntedjtelow), <br /> 1439463 <br /> t has been p�gpa ed for matlmg to acvordance with khe dire hons Sor j I pat e dna does not comm eZegss itgdid or <br /> nonmatlable tenal [n yroJatrotr of khe applicable )ogkale rega7adon� T A T FULL rt IIIIII(I�I)VIII VIII(IIII VIII VIII IIII(II) <br /> RESPONSIBIi ITY RESTS 1YlTH THE GENEI;ATOR(JytAILE(2 R ANY V�OLATIO OF 18r CI l7l C <br /> MAY RESU1 f FROM 1'LAi )IvtPR6PRlt PtiOICG 1 .M9 IN Ttsd Vicon <br /> this Flgrtk t #I(y PnBcura�ely deSdtt above 5y pmg naifie 3 are�c� ijae a ani T <br /> labelgd,$tld seer cpndthonfior cair[agels acgordrng to l ational governmetltai ghh S <br /> 11181017F Regulated Met3rcas <br /> Date' neseri tion of Contents <br /> ;Y <br /> 1 Gener ati )Tnfnrmahon <br /> T <br /> i <br /> y <br /> n� <br /> - or sharps waste(as noted below), <br /> Addces does not contain excess liquid or <br /> �. <br /> I AM AWARE THAT FULL <br /> Crty= �' Zip TION OF 18 USC 1716 WHICH <br /> I also certify that the contents of <br /> Telephone(R 77are classified,packed,marked,and <br /> regulations." <br /> tficafto ; <br /> >, <br /> I � J° al Waste <br /> COMMENTS . <br /> .. `. w.v_6094929 001 . SG3 XF <br /> w <br /> �. <br /> I FOR DESTINATION FAILITY USE ONL3z <br /> I certrfy khe cow nts of this package hnxt beeved tieated a(idihsp ed of m accordakJcetirbll 19te <br /> federal regulations ' ���� � <br /> Destination Facthty Destmathon Facility Certtpic�tion I <br /> �iteTlGy���IIIC ( � = `i'nntTtame <br /> z% 50., 12© c7 v <br /> v <br /> IZ <br /> SWP�T9 X06{T2�� Date `ty <br /> 49 001 5G-V3-XFA <br /> Ili.CASE+CST 1 tEI;G NGY--0 --M DIS'COVERX LY <br /> T L 8Q0.d24 9300`CHEMTRE-C CUSTOMh1 1�fiUMB2 21132 <br /> ll local,state,and <br /> knce with a <br /> if <br /> WFjITE RETURN TO GENERATOR YELLOW SUPPLIER l <br /> cation: <br /> PINK `DhSTINATION BLUE ,GENERATOR- „ <br /> P 79-106-0213 � Date: <br /> ! a <br /> IN CASE OF EMERGENCY,OR THE DISCOVERY OF DAMAGE OR LEAKAGE, <br /> CALL 500424-9300.CHEMTREC CUSTOMER NUMBER 21132 <br /> WHITE—RETURN TO GENERATOR YELLOW—SUPPLIER <br /> PINK—DESTINATION BLUE—GENERATOR <br />