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,2 <br /> NON-HAZARDOUS 1. Generetors US EPA ID No. Manifest Doc. No. 2. Page 1 <br /> WASTE MANIFEST pf <br /> 3. Generators Name and Mailing Address <br /> Bnergy Puels Coal Inc. <br /> 4. Generator's Phone ( ) <br /> 5. Transpoder 1 Company Name 6. US EPA ID Number A. Transporters Phone <br /> 7. Transporter 2 Company Name 8. US EPA ID Number B. Transporters Phone <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number C. Facility's Phone <br /> 11. Waste Shipping Name and Description t2. Containers t <br /> Total Unit <br /> No. Type Quantity WWoI <br /> a. <br /> PCS BULB 1; 18 <br />G b. <br />E <br />N <br />E <br />R <br />A c. <br />T <br />O <br />R <br /> tl. <br /> D. Additional Descriptions for Materials Listed Above E. Handling Codes for Wastes Listetl Above <br /> 16. Special Handling Instructions and Additional Information t <br /> 16. GENERATOR'S CERTIFICATION: I cerary the materials described above on this manifest are not subject to fetlerel regulations for reporting proper disposal of Hazardous Waste. <br /> Pd ~ ed me ~ Signature ~ r ~ / / ~ / ~ r N pay` <br />S L ~ rear <br />R 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> <br />A Pnnted/Typed Name Signature Month Oay Year <br />N <br />S <br />P <br />R 16. Transporter 2 Acknowledgement of Receipt of Materials <br />E Pnntedlfyped Name Signature Monm oey rear <br /> <br />R <br /> 19, Discrepancy Indication Space <br />F <br />A <br />C <br />I <br /> sipf of waste materials covered by this manifest except as noted in Item 19. <br /> Signature Maim Peer <br /> a Q <br />..~~~ <br />TRANSPORTER #2 <br />