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Pfease ntor <br /> tYPe. )=o€mRpproved.016 No.2050-0039 <br /> t1NfFORAd HAZARDOUS 1Vierab,ID Number 2.Pago 1 ddf 3 Phoma 4 F mer <br /> WA$_M MMIFEST t a v, �" - - 7635165 FLE <br /> (f diffOrem�n mae5ng r <br /> Y/140 Ir. <br /> GeneraWs Phmoe: T _ ra <br /> r <br /> w. <br /> 6.Trw1oia,k),gsxvdrogr1lsit <br /> 7.Transporter 2 C trpany Name U.S.EPA ID Number <br /> 8. c3 a!�rjrsez?mI'S U.S.EPA ID Number <br /> 1630 W_ 1' �' <br /> LKG' 3,' .�.p <br /> S Prx"". F: J'E2i`in";ler t v;W f *Wrw�eh2.�w so n",rde�- st 1t�f113 <br /> 9a. 9b.U.S ?isr <br /> HM and PacicirgGroupfwgI) Codes <br /> 2. <br /> :' j td3s l ti wadsWS, '�Ztl'yq 1! si�1� w ,. :ovsr r�;rr I <br /> g, ( #irt stts a &M X OWL M .TM MWM5A6 fo Ala-ew id 0 VIM ..,a: T <br /> 3. x, 4 <br /> } <br /> 4. <br /> 14.Spec�a;HWKPV kWA0mz and Adm Information <br /> ftpww.QvxiCkU7A 2- 3. <br /> 15: GENEEu'iWWOFFEROWS CERT*rA-M-.I hereby dadmtim the marts of ihis co Ognirnenl mft*and accurately described above by she MW' ane are eassded,pa*age , <br /> marked and iabele&plawFded,and ate in aH meets in proper r for tta5pottarxM*q taapp�94noonatand na8ond govertxnetrtal regtWipes If WOUrt and I.the ftrnery <br /> Exporter,I cerlifythatthe conr!ertts of this oansigrxrrentnmbm to the tennis oftthe atlathed EA4Adm0A*WWffdof C <br /> I-tsry that id mUed in 4o CFR 26227(a)(ff i am'a WWtp=fty&rtxataor)or asm_ae i ty r)is t w. <br /> G,I� d ane .# .' mom Day Y <br /> 1 16:lnte"i 5onal ` <br /> El mw,.U.S. ❑Evw-ftan U.S. Post of sr"e%± <br /> 17.Trans Acknowiedqrwfof JI' <br /> T ?r i3arne Signak Mom Year- <br /> Z Tratspor w 2 - ypdSgnarine Mkxdit Day /Yea <br /> ., <br /> 18.Dwepancy <br /> 1$a.Docrepeacy lr>d cAm Space El wanes ❑Type ❑Rmdue ❑Partial Rejection ❑FA Rejection - <br /> 't$b.Atieinase FacaliQy(ar C�teiasarJ r" Mand9st Reference hfwahat: <br /> U.S.EPA ID Nurnher <br /> w FaCWS Phrme: „r"' <br /> w 18c.SOmt uo orfAiterm le F90*-(or Generator) <br /> E Morzlh Day Year <br /> d ' <br /> 19.Miaratdots Waste Report hent Method Codes(.e.,ales JDFhaVFdoHS Wa3lo ueaWWd,disposal,and rang Systems;) <br /> 1. 4 <br /> 1� 2 3, 4 <br /> 20.Designated Facility 0vmer of Dperatov Cefffiptiort of of hazardous n�riats covered by the eaccept as n*d in item 18a <br /> SwatureP[intedfr '[ , <br /> Day <br /> 2, <br /> EPA Foran 87(&22(Rev.12-17) Previous editions ate obsolete.r' <br /> TRAIN PORTER Co .Y <br />