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P4tL OF LADING/MANIFEST 1.Shipper's US EPA ID No.(If Applicable) Document No. 2.Page 1 <br /> 3 }utt$14sJ`I,C ;rrc+' & of <br /> 3.Shipper's Name and Mailing Address 4_)07- it <br /> 1.x°501 we3 s,i iP� rti tta°r.1 f f: <br /> (i1ytn 93e-:tftlt..E'T mC,lic-'f"ry <br /> 1—•,�wr tJ Ser�_P`� <br /> 4.Shipper's Phone( ,.. } <br /> 5.Transporter Company Name <br /> 6. US EPAID Number A.Transpoer�ters Phone <br /> SA'F t '6(L,FT, RYP E-,TlIE-i 1hE. yf-RC!0QVg-1; g5 <br /> . <br /> P.- tt 8. US EPA ID Number B.Transporter's Phone <br /> I. C n o r2 m � e <br /> . t4 �r..yr}' 3 ;' a F� .1'° r 13t,ii �Rl`dP4/ 1 ,INCI�(�1:Df�t:�t� �a`a'�.9w,���71 7 61 :"3/R---5'0 210 <br /> 9.Designated Facility Name and Site AddressF __C, 10. US EPA ID Number C.Facility's Phone <br /> 1-1-FAN HARBOW3 rfl_ DORADO, Ll <br /> ,309 TWIFTR I(.'AIN C T RC;L.[v <br /> €l- Dbt bbb AP 7 1,7.11- ART)(11f.:-)4a t'3t` f�E`1� �> r. -F 1.7; <br /> 11.Shipping Name and Description 12.Cont finers 13. 14. <br /> Total Unit <br /> HM No. Type Quantity WtA/ol <br /> a. $N 1,r-5171 AEROSOLS S k�?f�N F'l..l�t�E�l�,�31 ['= �E a.�)� F'4 <br /> AFI€n :1�"FNCa 1 F. CA!'s)C:FTY) ,' ��' / ��� � /00 <br /> b. <br /> S <br /> H <br /> C. <br /> P <br /> P <br /> E <br /> RT <br /> 15.Special Handling Instruction and Additional Information <br /> TRQQY CA 95377--9708 OLE <br /> I )FR131.A;E,Fd; <br /> r..'d't• HR EMERGENCY 01 ,-_8lfd0 46 -9 1 7CsV (�P( � S('' / TFTO <br /> AUT11 E- 9 "( SENT--F OR" BY GEN I'll RETATN SUB M <br /> DOT/pr-,FL. A. 7 6•43500 a 1027PA5 rr, C. D. <br /> 16a.US DOT HAZARDOUS MATERIALS SHIPPER'S CERTIFICATION This Is to certify that the above-named materials are property classified,described ka d,marked and labeled and are in proper <br /> condition for trans ortaon amordln to theapplicable re ulations of the De art nt T ns ortation. <br /> Printed/Typed Name / Month Day Year <br /> 16b.NON-REGULATED SHIPPER'S CER IFICATION: I certify the materials described above on this form are not subject to federal regulations for Transportation or Disposal. ' <br /> •' Printed/Typed Name Month Day Year <br /> T <br /> R 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> A rinted/Typ�d Nam Signa ,�/11 Month Da(y� Year <br /> N (w� �`/ Y l <br /> S <br /> P <br /> O 18.Transporter 2 Acknowledgement of Aecelpt of Materials <br /> R <br /> T <br /> P' ped Name Signature1 Month Day Year <br /> R Grp <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> L 20.Facility Owner or Operator:Certification of receipt of materials covered by this form except as noted in Item 19. <br /> I <br /> T , <br /> Y Printed/Typed Name Signature (A Month Day Year <br /> npnimAI _RFTI IRNI Tr)f1,1=N1=RATr1R n rnRne ntn n•t_ononi rnoron4rN <br />