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RECEIVED 2/5/2019 <br /> Please prirntgr type.(Farm designed trr use an elite(42-pitch)typawiiter.) Form.Approvad,OH18 No2050-0039 <br /> UNIFORM HAZARDOUS 1.GenaretQr ID Nthmber 2.Prig !of[11,Error a cY es ep ria 4,PAanjfast Traddn Number <br /> WASTE MANIFESTGft#)90248S35i w Lri � 5�1 go <br /> 5,Generator's Name and Mailing Address �: SKS <br /> Oenerator'e SfteAddrsss(if digerantlhan mailing address) <br /> tai:�t;aft Shop ij..,. L.4,r�1 St Cal.- ral)s; Shop .1.;;.... Lad <br /> carlm or's Phone:: <br /> E.Trans rrrt��e�i�rC(?-�Ta��y^��ra4 e r r_ 7 U.S.EPA ID Number <br /> Jf3 i,f I`-t",�G.G.P iT -s G��i } �Y 4r" - . <br /> 7,Transporter Company Name U.S.EPA tU W nber <br /> 8.Castgnated Fed til}'Name and Site Address taF E TY-KL.EEtJ 8 ISTFHss_ }.wmc- U.S.EPA fU Number <br /> 6000 88TH STREET <br /> f Spry 5 <br /> Festilitys Phare: _d.)..J,lo -A,„ <br /> Ra. 9b.U.S.DOT Description{Including Proper Shipping Name,Hazard Class,ID Number, 10.containers 1`.Fnrat 12.l nil <br /> HM and Paeking,Group(if any)) 13.Waste f«{es <br /> No. Type CuaN':ty Wtftl, <br /> 1. NUN-rROM FtAZAl'i 0LIS WASTE;., LIQUID fel" 8 � i4 <br /> 0 (AQUEOUS BRAKE CLEANER) S <br /> -A --- -- <br /> z 2. h!C #-RCCA e1AZAttlOUS WASTE, LIOUTE) ITE 13 4 <br /> (AGUEGUS PARTS WASHER SoLul"IjJN�3 <br /> 4• <br /> 14.Special Handling Inslrucfims and Additional Information 7 a€}: i~i ii ! a r r +r• t �Y <br /> � iib?� ? �.-'�,-?'C�,�;3 �C�l.�w):. �•a(7;�-� <br /> y <br /> 24 �f"jt�P EtPIr�^�'p��d�:NQ{ ��n.-810'/-468"1. ,60 :6314'r'�rE�."�.1�1—K 5,�.ENJ �.s�r y}--y� rr;; �}!� tF t� [/�j�,r'- i <br /> C] is lit i{.# EI" TT LIG I;I��i} �I.��:}�. 47��� (,F�"��)511Ii;.1"iu r"rt3" '�T.�:�..�:;'�ri"€�5 S ��� \y!'S.�� i�- <br /> 15. GENERATOR'afOPFEROR'S CSRTIFICATiON.1 hereby declare that the aontenb of this cohslgnment are Ul and emu& dascribad above b the o ar sh4 In n8me,end are classified, <br /> Y diY Y p rpP B packaged, <br /> maiked dnd lat>etedrplacardad,end are in all respe&a in props:Donlon for Iransport according td eppliaab!e Homatlonal and national governmental regulations.it export shipment and I am dle Peak* <br /> Exporter,I caft that the contents of t b coAhment conform to tha tarns of the attadjed EPAAcknovriedgment of Consent <br /> I oer8fy I)at Vtavraste minimiza8al statement iden4fied in 40 CFR 262.27(a)(t!I am a large quantity generator)a(b)(Sf l am asmak quantity generator s true; <br /> Gen°arat�ors! �t^s Print CyTypo Name Y Sigr>atu Month D/ay ear <br /> ,+r i l <br /> ,1 18.Entemefional Shipments, <br /> Indo t to U.S ❑Expaf"it.S. - Port of entryfoxit <br /> Transporter signature(far exports oil): Pate laarvrg U S.; <br /> lu 17 transRorter!(dcnawfegit ReediptoftA9tenals <br /> ransporfer' ated7Typa¢ <br /> 5 store <br /> rZda^t - Month Day Year <br /> �. Tran3pow 2 Prir tafyped Name SgBa€q e <br /> Meath Day Year <br /> 18:pisaspancy <br /> 108.Discrepancy tnOcation Space ❑ aardity ❑T e f� <br /> YP ❑Res due ❑Perrier Ro)act on _t Fu'I Rejection <br /> Manifest Rsference.Numben ' <br /> 18b.Alternate Facility(or Generator) U.S.EPA IQ Number <br /> U <br /> 18t.SgnaturaofAllernateFacRy(or Genemtor) y <br /> tz A4ar.Ui Oay Year <br /> z <br /> 19.hazardous Wasta Report Msnagamenl Method Codes(t.e.,codes for hazardous was-to daalment,disposal,and recycling systema) <br /> '1- —2. H 1 A 1, 3. 4. <br /> 20.Deslgnat acigty Owner or Operate;Certification of receipt of hazardous materials covered by the manifest except as noled in Item 186 <br /> PrintediT Mama Signature Month ba Year <br /> ..� Y <br /> i P F r11F7 •2 ( ey,�3-0, Plevi u ,Qtl'6 ns, 4 Rhe, <br /> .t ��;J• r! ..;�vt�� �;��i���r��:�,:�., <br /> DESIGNATED FactUnrrci GENERATOR <br />