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x~... ., wr.,*;.. <br />.'y- . ^~ <br />_ <br />~ <br />'~ <br />~ <br />r <br />~,. <br />' <br />-" ...-. <br />-:' ` ' NON-HAZI!'RDOUS 1. Generator's US EPA ID No. Manifest Doc. No. 2. Page i „`~ <br /> WASTE MANIFEST ~ <br /> 3. Generator's Name antl Mailing Address <br /> Enfrq~ F,.~ l S <br />e <br /> 4. Generators Phon <br />e ( 7~4 ) L 3 4 ,r <br /> 5. Transporter 1 Gompeny Name kM~ /F~~ _ /J 6. US EPA !D NumDar <br />6~C ~ A. Transporters P~ e7 ~ y ~ 3 ~6 <br /> ~ <br />' 7. Transporter 2 Company Name ~ 8. US EPA 10 Number B. Transpoders Phone <br /> 9.. Designatetl Facility Name and Site Atltlress 10. US EPA ID Number C. Facility's Phone <br /> <br /> 11. Waste Shipping Name and Description 12. Containers 13. <br />ToWI 14. <br />Untt <br />- No. Type Quantity WWoI <br /> ~C S ib t -~ <br />G <br />E D. n C ~j <br />/ <br /> <br />N <br />E <br />R <br />T' c. ~~ ~ ... /`1 <br />DD <br />O <br />R <br /> d. <br />' .r.~. ] .. .. _ _ <br />~. <br /> D. Additional Descriptions for Materials Listed ADove t E. Handling Codes for Wastes Listed Above _ r'~ <br /> b <br />s 15. Special Handling Instructions and Additional Information <br /> 16. GENERATOR'S CERTIFICATION: 1 certify me materials descdbed above on M' s manifest are not subject to federal regulations for reporting proper tlisposel oI Hazardous Waste . <br /> Pdn[ed?yped Name Signature Monm Day rear <br />T 17. Transporter 1 Acknowledgement of Receipt of Materials <br />R <br />N <br />Pnnted/Typed Name ~~ ~ ~` E~ ,iJOJ/Q <br />' <br />Signature <br />- Monm Day <br />veer <br />s ' e ~/ <br />R 15. Transporter 2 Acknowledgement of Receipt of Materials ' <br />E Pdntetl/Typed Name Signature Monm Oay Yeer <br />R <br /> 19: Discrepancy Indication Space <br />F <br />a <br />c <br />I <br />~ 20. Fadlay Owner or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19. <br />T <br />Y Printed/Typed Name Sign re Monm Day Year <br /> 6a Fua 1 e '' <br />xi <br />~. <br />~ TRANSPORTER#1 , <br />