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ULI Lu GUGI/ 07: 0.3 z0alao"Vou I.uL-u Jf GL.1HL WM_mIC r•Nl7G UD/ UO <br /> <br /> _. .... _.?. x"i"INAM <br />DOUS WASTE MANIFEST <br />NON-HAZARDOUS WASTE MANIFEST <br />5+ xi <br />` <br /> ; yr <br />? {: <br />" <br /> 44L <br />1. GerlaraW& US EPA ID Number mmav.4 DMM Mt Number 2 Page 1 of <br />- 3, Gt+ne i,- nQAdtlross 3. OMKaIinD 1.OOapan (N dilfooftli <br />- mu ft" Pwwe <br />f'1QCt1C F <br />1 <br /> E 1-25 Fmnbge Rd <br />12100 <br /> 818D KrgMEOA <br />(.of1yl11ont, CO 80604 <br /> Dupont, 00 80024 <br />' 4. Phone ( 1 803•265•t m 6. Phone ( ) <br /> 7. Transporter $1 Company Nwm s. US EPA 1D Number 9 Trensporler ai's Phone <br /> <br /> 10. TronWiter 112 Company N- 11. US EPA ID Number 12. Transpow lws Phone <br /> 13. DssrfllMted TWO Fadlty Name and S•de Address 14. US EPA 10 Number 15. Faatily s Phone <br /> Tourer Lsnc l <br />' X11 ? Torre: ? <br /> Ca mmm *. 00 A000W ? MW <br /> To <br />16. Waste Skipping Name pad Deseriptlon 17 Auled Weds Approval N and Exp. Ds$ 1S. Cwftwsta 19. Cbtisntity Unk <br />D. WWd <br /> T Down Ipm*w <br /> a ? <br />o Unlaeded gas contnminstedeoi 00 LOS 07M Y813784 YYor& <br />T-70M <br />•... <br /> i <br /> <br />' W b. ' i <br /> Z <br />W <br /> D '. <br /> <br /> d. <br /> <br /> 21. AdMonel DesolollonS ror Materiels Listed Above <br /> Z2. 3psdet l1anding I.Vi bons and Additional Infmmt n <br /> <br /> <br />r'Vwft pep.rdayew of w7+rd°"x M AL <br />4" br <br />GENEWORI CERTIt'"ION: 1 oodly nolsrlrs darotbea an qfb nwnYwt +uelod m hart ran <br />23 <br /> <br />; <br /> . <br />• <br />PrintedrTypsO N7 <br />.. <br />J <br />A <br />o <br />7 <br />IL Ado"m liar YIK <br /> <br /> <br />104 <br />V.40 <br /> <br />• <br /> c • <br />S <br />t <br />E/ <br />9- S <br />AL _ <br /> 24. Transporter M: AcknowledpemsM of ROCCIN of Materials <br />sbntn mr OF <br />r <br /> ° <br />a <br />w PnnlsdrTyped Name <br /> <br />l f a Qj 1?{c+ <br /> <br /> f?4 TisnsposwAV Acknowledgement of Receipt d Maledfds <br />25 <br /> <br />o <br />Q . <br />5 "ww <br />Arorrs <br /> PrinledlTyped Noma <br /> <br />' <br /> 26. DiSCIM ry tnd=Ucn Spwar <br /> <br /> <br />Q? J <br />v <br />27. Faetlly Oanrr or Opnalor: CoMfiealbn of me*" of weals materials eovaOd by true maNtest (exrxpt an nOtstl in Vern 19) <br /> <br /> ` <br /> .? .• ?, <br />• ewro ,¢ <br />Prime <br />. mm* oar ttiar <br /> 15 r <br />i <br /> <br /> ' `. : , • :'"i .:' ORIGINAL RETURN TO GENERATOR ? '.'?:: ; ?••?-?' <br /> <br /> <br />