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<br /> NON-HAZARDOUS 1. Generators US EPA ID No. Manifest Doc. No. 2. Page 1 <br /> WASTE MANIFEST <br />. . p1 <br /> 3. Generators Name and Mailing Adtlress <br /> Snergy Fuels Coal Inc. <br /> 4. Generators Phone ( ) <br /> 5. Transposer 1 Company Name 6. US EPA ID Number A. Transporters Phone <br /> 7. Transporter 2 Company Name B. U3 EPA ID Number B. Transporters Phone <br /> 9. Designated Facility Name and Site Atldress 10. US EPA fD Number C. Facility's Phone <br /> 11. Waste Shipping Name and Description 12. Containers 13. <br />Total 14, <br />Unit <br /> No. Type fluantity wwa <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 /> d. <br /> D. Atlditional Descriptions for Materials tistetl Above E. Handling Codes for Wastes Listed Above <br /> 15. Special Handling Instructions and Additional Information <br /> 16. GENERATOR'S CERTIFICATION: I cenity the materials dascnbetl above on Nis manifest are not subject to rederal regmations for reporting proper disposal of Hazartlous Waste. <br /> Pd a me Signature ~ ( <br />h <br />S~ ~~-f' rn Day Year <br />R 17. Tansporter 1 Acknowletlgement of Receipt of Materials <br />N Pdnterl?yped Name Signature Monm oay rear <br /> <br />S <br />P <br />R <br />18. Transpoder 2 Acknowletlgement of Receipt of Materials <br />T Pdntedfl'yped Name Signature Month Day Year <br />RE <br /> 19. Discrepancy Indication Space <br />F <br />A <br />C <br />I <br />L <br />I 20. Facility Owner or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19. <br />T <br />Y PdntedRyped Name Signature Monts ay Yaer <br /> Yickie Fuselier Q <br />~_~~ <br />TRANSPORTER #1 <br />