GENERAL35702

• Permit No: C1980002
• IBM Index Class Name: General Documents
• Doc Date: 6/16/1993
• From: GUNNISON CNTY ELECTRIC ASSOCIATION INC
• To: O C COAL MINE
• Permit Index Doc Type: GENERAL CORRESPONDENCE
• Media Type: D
• Archive: No

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1. Generator's US EPA-ID Na. ani eat
Document rJO . 2. Page 1
MANIFEST /BILL OF LADING . of
3. Generators Name end Melling Atltlress O, ~ ~aC/ M(..p ~ A. $tatB ManHeat Dowmeri[Numlasr
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1. Generator s Phone ( i ~ n ~ 1 ~ y /- nu
5. Transporter 1 Company Name 9. ,US EPA ID Number C. SteteT uporOSfs ID
IRVIN OIL
INC.
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t304 Park Avenue. Canon City, CO 91212 - [phone] COD 9 8 2 5 9 9 5 1 6 D. Treilaportera Plane
7. Transporter 2 Company Name ~ 9. US EPA ID Number E. Store Trerspodera lD
' F.7rareponera Plime
9. Designetrltl Facility Name and Site Atltlress 10. US EPA ID Number G. Stele Fedldya ID ,
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H. Fecitllys Ptime
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11. Shipping Neme/Description 12. Containers 13. 14,
Total Unit
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Additiona^l,Descriptions for Materials Listed Above _ ~~// ~' '
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15. Special Hentlling Instructions antl Aotlitional Information
16. GENERATORS CERTIFICATION: I hereby tleclare that the conlenl9 0l this Consignment era fully antl accurately da9cribed above by
proper shipping name end are classified, packed, marked, and labeled, 'and ere in ell respects ih proper condition for transport by highway
acoortling 1p BDPliceble international antl national government reguletiona. ,
It I sm a large quenitiry ganerebr. I cMiN thei I nova s program in prep 10 reduw lM volume end toikiry OI ovule generated lp the degree I Dava tlelartnmetl 10 be ecmomicieiN
prulicable end Met I Deve selected the prachceple metho0 OI Iraelment, alprage. or diapotal curtenlly avadepfe r0 ma whr~ mrnrmaes the preuni end future tluml to Duman
heslih end the environment: OR, d 1 em a smell quan~tiry Banerabr, I nave made a good laiih eHOd to minimixa my vrafie Beneralion antl select the Dal weals meriegement
method that is aveileDle to me antl that I can allortl.
Printetl/Ty rb Name Month Day Yeer
Signature
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T 17. Transporter 1 Acknowledgement of Receipt of Materials
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Print Signature Month Dey Yeer
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p 19. Transporter 2rACknowletlgement of Reciepl of Materials 'r ,
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Yp Month Da Yeer
Signature Y
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19. Discrepancy Indication Space ~ -
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T 20. Facdny Owner or Operator Certdttalion OI receipt of malenals covered by this menlle9t eacepl a9 noted m Item 19. '
y Printed/T yped Name Signature Month Dey Yeer
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