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case print or type (Form designed for use on elite(12-pitch)typewrite[) •� <br /> NON�HAZARROUS 1 Generator ID Number 1 2 i2a§e 1 of 0cEmergenoy Response Phone 4 Waste Tracking Number <br /> WASTE MANIFEST CAD029503703 €� 1, "209-4847321 ,41 A a <br /> 5.Generators Name and Melling AddressGenerator's Site Address than mullings ress) <br /> y i <br /> STANLEY ELEG tRIC MOTORS <br /> 1520EMINER ' <br /> Sr[rGItiTdNA 0520 <br /> Generators Pho - - <br /> 6.Transporter 1Company Name - U.S EPA IDNumber <br /> AMERICAN VALLEY WASTE OIL, INC. CAR000272302 <br /> 7 Transporter 2 Company Name "- �+ � U.S.EPA ID Number <br /> Veofla ES Taohnloal`Solullbns,LLC NJD080831389 <br /> S_Designated Facility Name and SlteAddress U.S.EPA IDNumber <br /> VEOLIA,ES TECHNICAL SOLUTIONS,LLC AZtltl063373601 <br /> 5738 W.JEFFERSON ST. <br /> PHOENIX,AZ 18043 <br /> FacilitysPhone802.233=2985, _ <br /> 9, 9p U S,DOT.Descrlptlon(Including Proper Shipping Name Hazard Class ID Number, 10.Containers 11 Total ' 12 Unit <br /> HM and Packing Group(I any)) _ No`, Type Quantity Wt Nol <br /> a Lm11uERAL WASTE Dar_xA LtYrEo,USED srRalGHr LAMPs 'a F <br /> 2 UNI�lEREAI WA rf �14RJ C90f'REOULATED,BATTERIES,DRIB, i DF 2s^. P , <br /> trt�S.,ALKALINE fa1 <br /> 3 UNIVERSAL WASTE NON DOT REOULATED> BATTERIES,DRY, y2f/ DF Z0 P <br /> NOS.,,*NI�ADMIMH <br /> M44 <br /> 44+UN3094rs, LOTH UM ATTERIES,0,PGII,USED BATj REIES,TAPED I P 1 <br /> Al,a! a l eyrc- <br /> 13.Special Handling Instructions and Additional Information <br /> 1,PROFILE€8 "I'' 2 PROFILE#891188 3,PROFILE#&91180 4.PROFILE#893201 <br /> EMERGENCE 06 WAGE KEODKA „ <br /> 14. GENERATOR's CERTIFICATION: Icertify the materials described above on this manifest are not subject to federal reguiaflons for reporting proper disposal of Hazardous Waste, <br /> Goner tcrsfOfierors PrintedrFyped Name 6.gna r_ f _ - Meth Day ,Year <br /> 15,Internatmnal Shipments <br /> z -❑Ilnpodto US ❑Export from US., Pon.of entry/exit: <br /> - <br /> Transporterslgnature(fore) Date leaving U.S.: <br /> w 16.TrensporterAcknowledgment of Receipt of Materials <br /> aTranspo r o nntedb ped Name - _slgnature , Month Day.. Ye r <br /> N ei Pr dt ed Name '* - <br /> yp Signature Month pay Yea <br /> w_` <br /> 17,Discrepancy <br /> 17a,Discrepancy Indication Space -❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest.Reference Number: <br /> 17b.Alternate Femlil (or Generator) - U.S.EPA ID Number <br /> U ; <br /> LL Faddilys Phone <br /> 17c:Signature of Alternate Faclllly(or Generator) t t Month Day Year <br /> p <br /> 18 Goolditated Faculty Owner or Operator Gentlemen of receipt of materials covered by the manlfast except aa`ded i�Item 17a <br /> Pr did me - Si taints Month Day Year <br /> 6-NH -C-11 .., <br /> 2-DESIGNATED FACILITY TO GENERATOR <br />