Laserfiche WebLink
Slaleoftaldomia—Environ rot ProtectionAgency <br /> FppYm Na 20 39,IE pnes 9 301.99 wr See Instructions on back o ige b. Department OF Ta,ia sa6.anae:ca <br /> se. Pte Form Mar ed/q5' se on efke(t Sacramenro,California <br /> 1. Generator's US EPA ID No. Manifest Document No, 2. Page I Inlormatian is the shaded <br /> UNIFORM HAZARDOUS areas <br /> isnot required by Federal law <br /> WASTE MANIFEST Of <br /> 3. Gederators N e and Mailing Address'A A. Stare ani fest Document Number <br /> Uni ed Rxntala <br /> B. State Genermors ID <br /> sNry a. �, �Sane�harter Way, Stockton, Ca. 95205 <br /> 04 gig cl�ul <br /> N 5. Transporter 1 Company me - 6. US EPA ID Number C. Seethe Transporter's ID[Reserved.] <br /> h <br /> D. Tramporter's Phone <br /> m 7. At Mvien 5 PA6 m r E. State Transporter',ID IRes=�.� - _ • 'r <br /> _ F. Transporter',Phone <br /> Q <br /> Lou 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Faciliry's ID <br /> Q <br /> �Z D/K ENVIRONMENTAL , <br /> a H. Fa<iliry's Phone <br /> I.,,,O 3650 EAST 26TH STREET, LOS ANG A 9 3Its <br /> Q Is <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 1 ontainerP 13. Total 1 A. 'Unit <br /> G)V P [�" R p PVI B No. T pe Ouantiry Wt/Vol I. Waste Number <br /> Z a. Stare <br /> NON—RCRA Hazardous Waste Solid <br /> 3 G (Absorbent b Oil) r r EPA/Ocher <br /> o N b THIS VYASTE STfE#M HAS BEEN Stare <br /> QI1111! CEO <br /> E FOR RECYCLING/TR AtktNTfi- EPA/Other <br /> R e n," re <br /> State <br /> o T CALIFORNIA.THIS FACILITY HAS1TTIE~ Y <br /> EPA/Other <br /> °° It PERMITS TO WEIVE YOLRJTTI70 <br /> d. . QUALIFIED. OUR EPA NUMBER IS CATjI state <br /> Z <br /> W EPA/Other <br /> V <br /> W <br /> Z <br /> J. Additional Descriptions far Materials Listed Above K. Handling Codes for Wastes Gsred Above <br /> G. lla) Profile# 290311-09 6. <br /> 3X55_Gi'f3C Dr^ S <br /> a. d <br /> a <br /> Z15. Special Handling Instructions and Additional Information <br /> z HANDLERS BE 40 HOUR OSHA/SARA TRAINED <br /> = AND USE NIOSH APPROVED PPE. <br /> 16. RTI ATI N: ere6y scare at aka all of this consignment are full n ac<umtely esribsd above by proper ship ing name and are classified,packed, <br /> V <br /> marked,and labeled,and ore in all respects in proper condition for transport by highway accor ing to applicable international and notionoPgavernment regulations. <br /> If I am a large goantiy generator,I certify that I hove a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> a practicable and that tease selected the practicable method off treatment,storage,or disposal currently available to me which minimizes the Present and future threat ro human healtUah <br /> and the environment;OR,if I am a small quantity generator,I have made a good faith effort to minimize my waste geneWfoa and select the best waste management method that Is <br /> 0 <br /> available to me and that I can afford. // <br /> y Printed/Typed Nome Signature �,� / Month Day Year <br /> Z I !� <br /> T 1 cm r PtE nowt em nt cf-Materials <br /> R <br /> w , Printad/Typed Name ( Signalers Month Day Year <br /> W ? <br /> u- 0 r s r2Acknows ner nto atarials �- <br /> E Pdated/Typed Noma - Sig re Month Day Year <br /> T <br /> W E , <br /> Q E <br /> V 19. Disoepanq Indication Space <br /> Z F <br /> _ A <br /> C <br /> I <br /> L <br /> [ 1 20. Facility Owner or Oner.,or Cotification of m,eiFo of hazardous materials covered by this manifest ezce t as noted in Item 19. <br /> T Prinred/Typed Name Signature - Month Day Year <br /> DO NOT WRITE EL W THIS//, 1 E. J; <br /> Yellow: TSDFtSEGBb-L--.',S/': <br /> IGenarxws .. ,_ <br />