Laserfiche WebLink
Plea,l•pr it of type.;Farm de-srgrsed Far use on elite(12-pitch))pewriter.) FortnAparoved-aA+B No.2�5O-0f�39 <br /> UNIFORM RAZARDOUS Generator 1p Nlsnber 2.Page 1 0' 3.Emergmvcy Response Phone 4,Ma'}n ++ Tracking ma r <br /> WASTE MMIFEST "Vol .,., U 1 �� - J v JJK <br /> 5 Ck,t4kes Nasse and frf hV Addrm Ge�era!Vs Siva Address{dd*mrt than meirrg eddfeee} <br /> -•r'nr 1002to o - 2041 �wT Ler <br /> AL"f VIT <br /> CIA lw*4 <br /> 'r;rrrato•a Phgle: -S 510-6179 <br /> 6 TrAnspLftr 1 Nude U 5.EPA ID Number <br /> Tra"St=rer?CoMpaeY Ke' U.S.EPA ID Nvrrl*r <br /> 1-dl FAOIO Nam*and SkAd*m US Etalt IDNwAw <br /> rwi rxtitaem <br /> ■rth Almm*h ■>�r+Ffa[. <br /> -q, C3 9"72 <br /> Fac".-pane; �1M—"7'7114 1 0013 157 <br /> oa 4b U.5 DoT Desc+4llon 11^ckdng Proper%009 Narne.Hazard Gass,ID Nurnha 1p.c0rl arsit Talar 12 unit 19.Vh�ste Cartes <br /> hM ahc Pa�rinG a0 i1+r+YJI No Type Quant N VA No. <br /> cc <br /> Z <br /> x <br /> W <br /> L7 <br /> 14.Soecud Nw:gr.g Instrsk^Ww and PddlYdrral Infor mhon <br /> i. <br /> Z t j aww✓< provar VM cloLklI1q; " err —1&K^ Ive maxwqwmay IxIIIIIIItamm C31mmucc rsmarc� <br /> 1= GENERATOR'S.OFFERdR'S CERTIFICATION;I herebydldam Dot the contents of Cts corlsignme nt are fully and amwaldy Cesrrted ahm'e by Ow proper shippLrtg Hallo,and are d ns feed,paha*. <br /> morxed and labNedrpkKaW t and ere In rv}respects In proper Condition fa hanspo'I according Ie apyt�ckla intemadonaland national governrnentak regulagon5 If <br /> E+x4w.l owVy oral the mnlants of ws Irl orxb tsbrm 4 torms d me seadred EPAAci,wmedgmm,m Consent sxpwl � lam ,nary <br /> P <br /> l oertdy urettife waste rlrniniratlon stalorrrarr!lderrtifisd h 4tJ CFR�a2.2;i a r' am a large grwnJry generator)a f b;(dl am a small quaniiry Qerra�ttp'1 a true. <br /> Gene A2rgpfferces RnnlalTyped Now ,1rre Nionth pay Year <br /> In'- .d=[rta:Shprtrenls ❑knparttraU.8. l Exportf r,.U.S Portofentylerit �. <br /> 7ranspcnersr9nahlre ifOr Bi�O11e pNyi pate leamv US.-. <br /> 17 Trr'_F'rerAdnunledgiRmc4RecKoufMater s <br /> LU <br /> Tramp^Her t FnnMfTyped Name SH(ralura Mone, Ch, Year <br /> 4 <br /> Z Tran'--'e :Pnn%"avPe4 Nan* slgnahn :'.-'a pay Year <br /> rr <br /> t— <br /> ,� p�s�epancy <br /> 180 olwaaaniy inalcauoa Spix ❑ � E type ❑peg r!L' �—+C I. .Parker Re echo ❑Fv'RcyeCSon <br /> MarVestl7*mrw:aNwbb r. <br /> 19b Ai!?r^a?Fapldy IarCrarerlarJ U-G.EPA Ip Number <br /> U <br /> rat Fanlitr's P�Lne <br /> wra. cfg^al.•ecdA3temateFapll}torGerror} <br /> � hlGrlh Da} Year <br /> i9 Haz3rj-,s Waste Report Maragemenl Alat)rod Codes Ri•e.,codes brhazardorrswaste Vea?men degvsa%and•ec}d:r•g systerrul <br /> 2. 3 4. <br /> 20 pe stmt ed Facdt;Nrc-r or O3?ra r.Cen&abw of reeW of huardous Illemdds crosx-d by the rrl2mbg exbo m noW ie hem 18a <br /> Prnl07y:,:14rr.r. Signature "-r,l Ca: Yee, <br /> EPR Fuim 2TC •e2 fRev.3-05) Previous eftws are obsolete. GENERATOR'S INITIAL COPY <br />