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---�- - -_,_ RECEIVED ON 09/28/2022 VIA EMAIL (4 OF 6) T- _-� �• I Limn designed for use on elite (12 -pitch) typewr ter,) UNIFORM NgIgaDOUS r• G.n.ntar ID Number WASTE MANIFEST z. Pag. r or a Em. g.n an Form Approved. OMB No. 20W0039 _ ry P°^fO P �maiilng b.Generators Name and Mailing Address FLGenerators Site Address (d different tdress) nemlors Plrorrc: �r.-•fir' T,L; ,t �'. Krcfn o,•, -_ _'S? H�r_ryrr La.r- Pant' Name om _ 7r:6 -61;i5 a. Designated Facui Name and Site Address L' Gh L-C"Cr ` Facility's Phone: J ga, 9b. U.S. DOT Desc"ption (including Proper Shipping HM and Packing Group (I any)) Name, Hazard Class, ID Number, . -.i!:4 :eL liG`i'Cr! 1sC (f'.t'.� :.•/.l a, :..�y '�. fs G 71G'r.:t C.. .> T 1�^75 O 0 co 0L C1= O �. ---�- - -_,_ RECEIVED ON 09/28/2022 VIA EMAIL (4 OF 6) T- _-� �• I Limn designed for use on elite (12 -pitch) typewr ter,) UNIFORM NgIgaDOUS r• G.n.ntar ID Number WASTE MANIFEST z. Pag. r or a Em. g.n an Form Approved. OMB No. 20W0039 _ ry P°^fO P �maiilng b.Generators Name and Mailing Address FLGenerators Site Address (d different tdress) nemlors Plrorrc: �r.-•fir' T,L; ,t �'. Krcfn o,•, -_ _'S? H�r_ryrr La.r- Pant' Name om _ 7r:6 -61;i5 a. Designated Facui Name and Site Address L' Gh L-C"Cr ` Facility's Phone: ga, 9b. U.S. DOT Desc"ption (including Proper Shipping HM and Packing Group (I any)) Name, Hazard Class, ID Number, . -.i!:4 :eL liG`i'Cr! 1sC (f'.t'.� :.•/.l a, :..�y '�. fs G 71G'r.:t C.. .> •-..i.C•tIlt: lT�a.�. ::31Z:dL�S7i9!j II -T-3302 v ,-til: 10. Containers 11. Total 12. Unit Tlbb Quantity WtNol. 13. Waste Codes I T —7 E`er.. [�55 Y •. J. .. `a 1�� ars mn ,ate �� tY'L,tts F t:a:u?.pt•.i1ez[:�.:."-d a;.t"a n::.,-,�'CR:: IIL:sp;sal. °e:.*ric�i•- �� _ .-.. _ 41 15. GENERATOR edIPEROR'S CERTrFICATION: 1 hereby declare tltat the contents of Uti cons gnment are fully and accurately descr bed above by the r shipping marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable intemational and national governmental reputations. If export shipment and 1 am the Primary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent P� pomp name, and are classified, packaged, I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small uant. Generator's/ ero s Print ype Name , q ty generator) is We. J Igoe re 4 i 1r on ay ear -J 16. International Shpments l ❑ Import As. Z Trans orler si nature for exports only): ❑ Export from U.S. Port of entry;exit W 17. Transportelft-Owledgmerd of Receipt of Materials to leavfnq U.S.: we Transporter 1 Pdnted7yped Name CL Transporter 2 Printed/Typed Name C I.- 18. 18. Discrepancy I 18a. Discrepancy Indicallon Space ❑ Ouanbty 18b.AltemaleFacility(orGenerator) ___ mor rrer ire ignalure ' � L? t -7 ont ay Year Type ❑Residue ❑PadialRejection ❑Full Rejection i Manifest Reference Number. U.S. EPA ID Number I Month Day Year 5 19. Hazardous Waste Report Management Method Codes ('.a., codes for hazardous waste treatment, disposal, and recycling systems) u 1 1 1., 2. 3. 4 .. ...... aralinwe wwr.sawlattaw — i;} i flMl R 11 \ 9 T Y r Ilei