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Stall• of California - Ciililornra E nvv;mmenlal Plolecbon Ayuncy I.tunanment of f oxic Substances Control I <br />Transportation Unit <br />wirio Cal r:pnlpr nrivp Sacramprtn CA 95119126 <br />Phone (916) 440-7145 Fax (916) 255-6436 <br />CONSOLIDATED TRANSPORTER NOTIFICATION <br />_ -- <br />1 Business Name (Show d.b.a name, show name exactly as it will appear on registration, same name 2. Transporter Registration Number <br />or trademark is reclunod on all vehic(es)' <br />I I <br />Asbury Environmental Services 0 0 1 5 <br />3. Business Address Number/Street <br />City <br />County/Province <br />State/Country <br />Zip/Postal Code <br />1300 South Santa Fe Avenue <br />Compton <br />P <br />Los An 8 <br />USA <br />CA/USA <br />/ <br />90221 <br />4 Mailing Address (If different) P.O. Box/Street <br />City <br />County/Province <br />State/Country <br />Zip/Postal Code <br />Same as Business Adress <br />5a. Telephone Number (Ext. Number) <br />6. Identification Numbers. If your company transports hazardous wastes, operates the designated <br />facility, and intends to submit only the facility copy of the consolidated manifests pursuant to Health <br />and Safety Code Section 25160(b)(5)(A), you must provide all the transporter and facility identification <br />( 310) 886-3400 <br />numbers (12 characters) used by your company on these manifests. If necessary, list additional <br />_identification numbers on a separate sheet. <br />5b. Fax Number <br />310 763-5922 <br />1 CAD 028 277 036 <br />5c, E-mail Address <br />rdomino@asburyenv.com <br />7. 1 intend to transport the following hazardous wastestrearn under the consolidated manifesting procedure, as described in Health and Safety <br />Code, Section 25160.2. [Check all applicable box(es)]: <br />Used oil J. Spent photographic solutions <br />B. Contents of an oiVwater separator K. Dry cleaning solvents (including perchloroethylene, naphtha, and <br />tCA. <br />. Solids contaminated with used oil silicone based solvents) <br />. Brake fluid / L. Filters, lint, and sludges contaminated with dry cleaning solvent <br />E. Antifreeze /4Jv M. Asbestos and asbestos -containing materials <br />F. Antifreeze sludge 7C N. Inks from the printing industry <br />G. Parts cleaning solvents, including aqueous cleaning solvents )(0. Chemicals and laboratory packs collected from K-12 schools <br />�H. Hydroxide sludge contaminated solely with metals from a wastewater `) P. Absorbents contaminated with other wastes listed in Health and Safety <br />treatment process Code Section 25160.2(c) <br />I. "Paint -related" wastes, including paints, thinners, filters, and sludges �¢. Filters from dispensing pumps for diesel and gasoline fuels <br />8. Name a of Authorized Representative (print or type): Rosemary Domino, Director, Environmental Affairs <br />4/8/10 <br />Signature of Authored Representative Use blue or Other non -black ink Date <br />Note: Keep this Consolidated Transporter Notification, signed by DTSC, with the valid Transporter Registration <br />Certificate in the vehicle at all times during the transportation of hazardous waste. Transportation of wastestream(s) <br />listed above, under the consolidated manifesting procedure, without notifying DTSC is a violation of Health and <br />Safety Code (HSC) Section 25165(a), and may be subject to significant penalties. Consolidated transporters are also <br />required to submit quarterly reports pursuant to HSC Section 25160.2(d). <br />DO NOT WRITE BELOW THIS LINE FOR DTSC USE ONLY <br />Transportation Unit Representative Received date <br />P,�9 <br />till _3J , <br />(Print or type name) apiratidn date <br />MAY 2 6 2010 <br />DTSC acknowledgement date <br />DTSC 1299 (7/09) <br />