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N <br /> all <br /> Form OMB No.2050a39 <br /> Please prist,or Vree.(Form designed for Ilse on 011B-(12-Pitch)0e%4Ttvr.) Approved. <br /> 1,G6naraky 10 NuTZ-a—anifeotTradd Number <br /> 1 UmnR,M HAZARDOUS rnbar Pap i d� 3.limareervy RaSponse Phoma- 3-053 JJK . <br /> �i4fli MANFEST CAL000J.32645 T (9001424-9300� �o 10, ucmimorotw Addross(if cruward than miling address) <br /> �jarns and MaRng Address <br /> P--t BE#2322 <br /> 50 3E RD. <br /> LOC),' <br /> S5240 <br /> WWto?PrhTn 205_33902W U.S.EPAIDNwrio4T <br /> -nw-*—�x CA00282T7036 <br /> AS60RY ENVWRIVENTAL 8MVICES <br /> 7.Transporter 2Company Name <br /> 1. ". U,S.EPA IDNIumbar <br /> 8-W-06W WIN N, d SitaAddress <br /> Wis IN MTRY,INC. <br /> UTH BOYLE AVENU E <br /> ELES I Qq <br /> FaciTtft Phw a: I(37M277-1500 10.Containers 11.Tbw 1Z Unk `13.V&SW Codes <br /> 9a. 9b,U.S.DUI'Uasmiptli on(Ud4ng Proper s1r;*g Name,Hazard CL,-,,--ID Nwbar, NO. Type Qwm wdw- <br /> Hh, <br /> 52 <br /> Cf- XONRCRA HkWbous WASTE.SAID(OILY SOS F --- <br /> 0 <br /> tu <br /> 3. <br /> OCT 06 2014 <br /> 4. ENVIRONMENTAL H <br /> DEPARTMENT <br /> i4.Sp-dal Mand Mnatti-abom and AdMwal eWl'11W EC i_SN424.9200 RAr:RG#9Si-171 PROFILE#581 AP;16729S OILY <br /> EMERGENCY CONTAa:Cli EMTft <br /> zql <br /> SOLIDS*FGHA110i62581. Q�n <br /> ' ') 13 —--sstn�,pea waged, <br /> rihmaby OW proper <br /> CMI,-Tkts of INS consignmentam Uly am accurately <br /> Primary <br /> WUately deq=au aww by 9ova <br /> 76: GENERATOR 0 LOR'S a=e-aelo <br /> marked and tabajg4ja.-dod,and we to a%mq)am in proper=,mon for MrAxyd <br /> Exporter.I caffy that Urs wAsnAs of this w*1MrIt=f0TM to the terms of t-0 aftched EPAA@moovfc4gment of am wW qw*gen r& is WD- <br /> Ice", =the wastea Dq <br /> 510bres fttdffyped Name <br /> n E*fMm US. pod of wtrftidt <br /> hwn to U.S. D lea;Vag U.S <br /> Transporter z1griatilm ffw wmwm may): <br /> Day <br /> U <br /> Trani P�ni <br /> dW4 <br /> ✓ <br /> w <br /> 0 vow <br /> fz <br /> ZTramp 2 PrintediCW <br /> pM Name <br /> Is.Discrepancy ❑Ty Partial Rowwon FW R,�.Won <br /> 18a.DSMIPM indication4acO 0 outil P- <br /> U,'5.LvA ID Number <br /> 18b.Altemaie-,soltY <br /> R <br /> . wio <br /> is Phone- In Day y0a, <br /> 18c.5IjnatwvufPjIum <br /> IM <br /> 4�c Ad <br /> cedes codes for waste traalrnwl�&POSK a <br /> t2 recycling Syyten v} <br /> 4. <br /> 0) 3� <br /> LU j. <br /> b 1111171182 <br /> Lrr Dwaly Year <br /> ,ji=_ad by the man w=pt as ndM <br /> 211-Dad�gvswd Fa nar or <br /> 'h9MIGNATED FAGILfl-Y TU Ot5TINATIQ jTATr.gr mr-mviRao) <br />