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o0 (D 2000 <br /> v ' <br /> O - m <br /> Z3 Lri -P, p <br /> v coonX0-0� 0 <br /> rnwo <br /> o <br /> 0 000 <br /> Q 4 N) 0 <br /> O C— C—�. 00 <br /> - - - -- - W <br /> = weaae pdnr pe o Iv CD <br /> r fV v <br /> (n UNIFORM 4AZAR g h.ce,wraio,rt Ndrrter Fe^n ` w.2„'f. ?4 CD <br /> WASTE MAkIFE37 �vaga�nr a Enprgrncy Respoyb Pada 4- <br /> SRenealosName rAL�9U112ta41 1 9fps-363-367001959� O Z <br /> so li tlmss .SJK ap-- — <br /> a09 '~ g1u'n • 8726 Generawrs She Addnha ld Baerwrt goyy nhalrrq egdns. <br /> ST <br /> CX, 95376 �, <br /> Renerpers Ph !I <br /> one: ? V Rqq–anFe (n <br /> Traheedfer 1 co",Neme Cl) <br /> us EPA.rp Nwar � 3 <br /> Tri,, �►sA�nous ■ws r:�ov�u aalc rrasez s <br /> sPoner 2 Company Name U1 Z <br /> US EPs 1O'hr•rdr �� � <br /> I a De5igiF am �q dress Marc CAR009199211 (7 <br /> CD G <br /> PECZCLAJDMA TE2/hti DE l6EYILLi U 5 EP416 Narrow �_ n <br /> + E•TEl811- PEON, ><b. 2 HEX, SAN PABLn TiCA'IF' FSC N D <br /> ' Fxiriys Phone: 6 � <br /> 19-270-9953 C <br /> sa 9b u s Dol 14 <br /> rDe-Idben{mdudirp Proper Shopping Name,Hazard Class,ID Number 10.Cants h1 7pfN 52.1M+t <br /> HM ane Pd[NIng GrWp(il any)) s3*00,Cadw )7 <br /> 1 No. Type ci—City w1.rW71 (D <br /> O Ca acct LS (Each Ho Ere..idl q 1.L <br /> FLN*LWLE, P.O_S., 2.1 1 000,1 Do 35 331 U) <br /> w � P <br /> w <br /> 3SpPBGPAYOL). 3, PC. II D001 D035 4'903 (D <br /> I p <br /> 37,1 a <br /> 3 C <br /> (VMAiSI11M P ALm, E S-iS- D001 191 <br /> Y LRSUIF'X S�I@i PESSQLEXTE), P <br /> 8-1, PGIII O <br /> 4 7 <br /> S ■ 2eE LIQQID 561 p> <br /> (DE7'EFGE8T3.GL2Cf3L5) fi � ^� p <br /> 14 Spacial Handling Inshuctons and Adtlrliunal Info 07 <br /> 1) )1Q91619 / (Atrosoi) 2) R / 1 p (Fla. Lig) 3) <br /> S) A 304 (NRL-{:P) <br /> F232 ICY EX:pOUTER: 1EMhC£Y BEC4CLIiG IIIC� oda! 13269-1 CD <br /> 75 GENE RATORTOFFERCR'3 CERTiFICATIOR:I hereby declare trial the contents of this wnsignment are fully and accurate described above b the Z) <br /> mediad and labeladiptacented,and are in all reN Y proper shipping nerve.and are oasslried.escaped. 0 <br /> respects in privrin condition far transport according to applicable inlematonal and nationsl govemmenhd regWafrahs.liexpert shrpnenti ane!am.Me Fid ryy <br /> Exporter.I cerfify that the contents at this cwtsignmenl wnform to the terms of the attached EPAAcknowlseNmenl of Consent, O <br /> I certify trot the waste minimization statement identified in 40 CFR 262.27(ai if I am a large quantity generalxr a{i(a1 am a small quantity generator)is afire. <br /> (•eneral0YelQgefol s Pnnredayped New Signature More Ugy yea �• <br /> .1 70.Inlematonal hipmentu <br /> i-- ❑Irnpat 0 U.S /,{;� ❑X Export from U.5 Purl of entryfehdi: L7 <br /> _ <br /> ? Twisporler signature(fa experts email: Dale leaving U-5.. / S <br /> 'X 17 Transport,A fedgment olIl of Materials <br /> ¢ Transporter I N me Signature Matti, pay yew <br /> O W <br /> a <br /> Transpafer 2 PrintedType+7 Name 5+gnalure pay yew <br /> OFC t'4ZZ- <br /> IS Discrepancy <br /> I- <br /> lea Discrepanq Indication Space ❑Quantity ❑Type ❑Residue ❑Partial RePd. ❑FW RM0. <br /> Manifest Reference Number <br /> r 780.Alternate Fdctllty(a Generatar) U 5.EPA ID Nurni <br /> 0 <br /> LL Facilitys Phone. <br /> i&S)gnarure of.Allemate Facprry{or Generates) Month pay yea <br /> I <br /> 4 <br /> Z (D <br /> ? T Hazardous Waste Report Management Method Codes(.e,codes for hazardous wade treatment,disposal.and rKWing systems) _ <br /> .tx.i7e.5,gnawd Fatitty Owner a DPerdter CerbObon of recetpl of lhaZaifli Mali covered by the manifest except as noted In Item 18a T <br /> p,,.gad,Typed Name Signature _ r ay Zl <br /> CD <br /> Cn <br /> � �PA 9ortn 8710p.22(Rev.12-17) Previous edilioPs reolysoaele. DEMNAMFAi 10 GENERATOR o <br /> co <br /> m � <br /> w <br /> cO <br /> 0 <br />