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<br />1 <br />1 <br />1 <br />1 <br />1 <br />Form ArpioreM1 OMB Mo. 1nSOMN fawn 9.]}% <br /> UNIFORM HAZARDOUS t~ Generetofs US EPA ID No. Manifest <br />m <br />nt No. <br />Dtxu 2, pee 1 Information in the shaded areas <br />9 <br /> WASTE MANIFEST G <br />i <br />J <br />E i i) G ! is not required by Federel few. <br />of <br /> 3. Generatofs Name and Mailing Address g & B E~CA'lATING, INC. <br />~ <br /> :~:, ..:, r ~ <br />' <br />s~rs-r~~rr-~ =y-i <br /> <br /> a. Generators Phone q70 .(f.-.3 ~ L ! tl Ilk / EASTMAN <br /> 5. Transporter 1 Company Name 6. US EPA ID Number ~+.SIBta: - <br /> '.;AFETY PILF.EPI :iEPV(rES r IG'~ INf; i n n o 'S T w :, •, ~ W..Ti®r~pOrE`et'e± .' <br /> 7. Transporter 2 Company Name 8. US EPA 10 Number E <br /> TR[-STATE ~n?Tf1R TRANSIT CO• to n a~ 5~ Z a c q .q <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number <br /> P,AFETY Fl_EEN tiERVILES WICHITA) r INC. =~ r <br /> :549 N. NEW YORK STRL-ET <br />. <br /> W(I'HTTA Hi r;i? 9-- q ~ '• n !, A .. ti aar. '. <br />< <br /> <br />11. US DOT Description (Inclutling Proper Shipping Name, Hazard Class antl ID Number) 12. Containers 13. 14. <br />Total Uni[ <br />0 „„ No. Type Ouan' WWd <br />E <br />N <br />a. <br />Non RegulateC Material <br />E <br />R <br />C i) ~ fr <br />r• ' S 4 n r: G, <br />A <br /> <br />0 <br />R <br />/ <br />r !t l) _ <br />~ ~ ! LI <br /> ~ . <br />t <br /> c. /ll,:n ~+ryyla ~f 1v~Ai pvr6 <br /> J 7~ r <br /> d. <br /> J. Ad}llbort~al mDe'scllpBons far'Met~~,esr~y(yeef~~sf,,J,~ystf~e.~+}d~~aaAtwVa > _ '° '• <br />.:!,~.+.•~( <br />1, <br />/' <br />t. <br />x.~f~3 i <br />R <br />:.i74L <br />{~~~ <br />F <br />~ <br />; <br />. tlJ~~ ' ~~ <br />~M <br /> ~ <br />~y <br />. <br />y <br />C <br />~~h.. <br />,w~,rf <br />} <br />y <br />j <br />~ <br />r <br />C'+t'XSS;~ tea'":' =r~~4rry7 '_~V~~~t'?~.'` v r <br />.~.,~i~ <br /> <br /> <br /> <br /> 15. Special Handling Instructions antl Atlditional Information C FG A : D: - FI <br /> 34 Hour Erargency Contact tl: B 3 B E'ff,AVRTINI3, INC. ERG R: N~A <br /> 3L-' ($l74't'~ v6B-1?60 (?25+ lY4°j5 HWy 6 5RE r_:NrR <br /> EAGLE, CO S[631 ERG G: <br /> 16. GENERATOR'S CER7IFlCATION: l hereby declare that ms wnlsnb pr tlaa consgmrreM ae hay and azuretely dsxnbed above by <br /> proper shipping name and are davrfiad, pecked, marked, and labeled, and are In all reapecb in proper cond'NOn for transport DY highway <br /> aaording to applicaDb imemanonal and netlonal govammem regulagons. <br /> II I am a large quantify genaretar. 1 caddy that I have a program in place to raduoe me volume and bxicily d wade ganeretad to me degm I have determined to be <br /> e[onomirally precdraDle antl mat I have seleme0 me precdcabls medlod b treetmem, storage, or olapoaal a+nently available to ms wnkn mmimizee the present ono <br /> future mreet to human heaah and me emmm~mem: OR, a I am a smell quenbly generator, I have made a goad Ieim 911od t0 minlmiz0 rtry waste generatbn antl select <br /> the best waste management method met is eveilab4 to me grid mat 1 cars edord. <br /> PrintetLTyped Name _ Signature Month Day Year <br /> <br />] f 7. Transporter 1 Acknowledgement of Receipt of Materials ' <br />w PrintedTyped Name <br />~' ~-l - ~ ~-~ ~~~~',,~ Signature ,/ / .f Month Day Year <br />iii;,, .~ a---~, - - <br />0 7 B. Transporter 2 Acknowledgement of Receipt of Materials <br />i Printedi typed Name Signature Month Day Year <br />E <br />R <br /> 19. Discrepancy Indication Space <br />F <br />A <br />C <br />I <br />l <br />T 20. Facility Owner or Operator. Cenilication of hazartlous materials covered by this manifest except as noted in Item 19. <br />v Printed/Typed Name Signature Month Day Year <br />' ®Ir~llm ARG1Gm..lee <br />mosorsrrr last <br />GENERATOR COPY <br />EPA Form B]bD-~1 (Rev. 9-ae) Prswaus aaiAOns ors oDwlsre. <br />