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Please prr l c•type-{Form dWgned laruse on ego(12-pIch)t rifer.) Form Approved.BOMB No.26513-0039 <br /> UNIFORM HADA MUS 1.Generator 10 NWtW 2 Page 1 of I Emergency Response Phare 4.Manifesl Tracking Number <br /> WASTE MAMIFM J J K <br /> -3 ;Name and kfairg Addreaa Gwwra,Ws SO Address II d:fierenl than maiNaddress) <br /> lr $ <br /> Phsna A 7► <br /> T•:;^;[-:r�r 1 C r;aly Name <br /> U.5 EPS iD'.•_— -r <br /> r T ••p n k A� for <br /> 7 2 Company Name U-S,EPA 10 Hunter <br /> C•-s p a:-e 4,iI4 NwM and SiteAddres6 u 5.EPA id Hunter <br /> Fa-dt,;[ ar.e fa ^}.!$AA1 f+,4%-r4 <br /> gd 90 u S.DDT (indo"Proper Shipping Name,Hazard Class,ID Number. 10.Canlarrra 11.Total 12 Unit <br /> HM and Padd%Cqw(M arryl) i3 Wa1M Coda <br /> f1o. T}pe Qrsarrll; WtNol. <br /> 1 <br /> 1oC iiia3atl'� lin Mlita tr(-1 0.1 <br /> u! <br /> x <br /> ••� srlrrua6-L--an}'t"Idw a ar y <br /> ar t{ ►�4 <br /> 14,%It a rt2wq " law J41e" 1,t4"1a <br /> d <br /> Speva'-ra dingb9nrMM end Addy MIl ktlomnktm <br /> "ire f YI Y. lil.'�llll Jt -t of 6 lr l+O•raaM 74:liar ,tl i i 64 7 2 if11e!_ <br /> M: flf r �lYlpf1i` PM Illaothstwl. CALGOMMra kM09}7 <br /> �.. <br /> WOW :. 1rPj Ira JPV74—t■ wrr r, <br /> 15 GENERATO,RVOFFIMR'S C ERTIFICAI ON: 1 heretydec'are mar!re czVe a of This car_:-•. ,;•e L*and O=aMly dWtted above by Ste pmpar shipping name,ars are[rasarwi pajagm <br /> r-arked and l:N"ptacarded.and are In al respects in preps•cmdition fottams acowding m appira3le interna0ord and national govemnwtW ragularions,fl wW shormera"I am ft P&mry <br /> raper,,i certify @rat dte omtenis of this axnonmenl confirm in the terms d me blra4hed EPA AJ mwledrjmenl ce Consert <br /> P Wr (tMI ala waste minMULan statement id)ntfied h40 CFR 26227(a)IK I am a large puJn[ty 9warj or)or,c fd I am a sinal quantity ger era,L-, rs true. <br /> Gene-a.ors011emes PrintedTyped Hants 9naIJ!e Monist tray ffiar <br /> 16 fa:+ma:,1alShgnt"U <br /> 11 Import 10 U.S. ❑E;partt-a.-n U.5 Port of ertayfink - <br /> Trar-WM r"Feature Ilor sopors pnlyl Date leavrq U.S.: <br /> 37 Tr ,trier Acir akEedgeerdef Rscagt OiMa sly <br /> Transpaner 1 P"d.Typed Home 5lgnatura ><rorrM Day Year <br /> Ca. <br /> Q TrdnsGOre•:Prnted yWNarre Srgnalure 6lonth Day Year <br /> GC <br /> H <br /> 1; D;:��eparlty <br /> t?a pr3pL+pancy lrtdlcaliott Sproa ❑ ❑Tyw ❑Residue (_PaMat Refection ❑FLA Relcct url <br /> Ma r 4 sr Reference Number, <br /> 1;�. 0•�r•-;+Pacdity Ia C,•znardt4rl U.S.EPA 10 Number <br /> FacWq+s Pnarw <br /> W 18[ .graf�aoi aGerxreter) Mom Day yea• <br /> a <br /> z <br /> 19 H ar..t..,s 1Ya57eRepat Management M1lentoC C[des(.e•,Codasl0rhs7arws+rasfeleaVrrerd.dilppsa,end re ysJ ng systems. <br /> -l 1 2. J- <br /> 20 <br /> DE'3 "ed Fad11y Oww .or Opgra,br Certification of receipt of hazardous rmbrk&�u.e•e'.:.. _^t ier' -1'as nded h Ilem lea <br /> Pnntn47}r-:N;me11 F.?-•t•n Ga: 'i e'• <br /> EPA Form�?f - (Rev.3-D.5) Premuseditionsare '•s -re GfrN5RATOfi'S IhllTiAL COPY <br />