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W <br />N <br />a <br />Z <br />0 <br />Z <br />NOWHAZARDOUS WASTE MANIFEST <br />Please print or type (Form designed for use on elite (12 pitch) typewriter) <br />CF14 02002 LABELMASfFRQD (800)621w5808 <br />I.GeneratoesUSEPAIDNo. <br />Manifest <br />Document <br />351999 <br />��' <br />3, Generators Name and Mailing Address <br />aftlrn <br />i _ initmi Am <br />4. Generator's Phone( <br />5, Transporter 1 Company Name 6o <br />US EPA ■ Number■ <br />f. <br />r <br />i <br />MM r45®rNPV=6%1'TAtA9fflu1.� <br />■ <br />D. <br />• ■ 1 <br />'£ <br />■ <br />■ <br />L <br />lei <br />Fa Facililys Phone <br />209472422SI <br />11,WASTSDESCRIPTION <br />Containers <br />No, <br />L Type <br />7 <br />EO <br />r! <br />MEMM <br />• <br />DescriptionsMEMMG. Additional <br />APO <br />r _'l <br />z <br />154 Special Handling Instructions and Additional Information <br />16.GENERATOR'S CERTIFICATION: I here certify thatthe contents of this shipment are full and accurately described and are In <br />4 <br />all respects <br />In propercondillon fortransport, The mate. als described on this manifest are not subject <br />to donall hazardous waste regulations. <br />oil <br />Signal ure <br />Month <br />Day Year <br />17, Transporter I Acknowledgement of Receipt of Materials <br />■:: <br />Day Year <br />18, Tiansporler2 Acknowledgement of Receipt of Materials <br />Date <br />PrIntedfTyped Name <br />Signature <br />Month <br />Day Year <br />19, Discrepancy Indication Space <br />PrintedfTyped Name <br />Signature <br />Month <br />Day Year <br />www.labeimaster.com <br />®� 4R0 W Rt�RFA a+ER Rh <br />u�+mmnc.,v..c �nINN <br />