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'� � 35S tttd�i�e i�c,ck Rd. n A <br />� Y �ya � :i } t � P 4�5� <br />k. . " ' .1 ,;' i�art��ta ��rduva, �% ����� �a�.e: ����� <br />.�1 i����: tai � <br />iNo be com�iei�ed k <br />,��,v��nw w..�._.__ <br />. __ <br />�y •the gener�ar�or: _..__..,.._� <br />I certify that the following information is correct, and I ha�c read and u�uletsand thr: r�equh�cmrnts rur pzutiripation �n tt�+r-'.t�ri��� (e Cundii'ir,n71P,� [ tcrnp <br />Smal! Quantity Generator �Nasee Acceptance Pro�,ram. r further certify Rhat t am a C:undittor,ai;y Er.crnp �n,tsii C%,at;ttly ��n � r:{:or �+ ('trt€nF rr by Fe��u<�i anti <br />C,�litnrnia Statc> Regulations, and this quantity or waste d��es not exceed the strccificii IUnits ror the type i�f vr<�..te h�>h�g diy,�o..ed. If +Lt> v✓astc i5lattr rotnid <br />b] exceed srnail quantity limits car contain materials not ,�cccpted under this prc��tran-. r agree t�� r_r�mt�ir,l.e a hsrardous w.�rsle ii�:'mi(e,t and cc.�7��piy �•�lD�h <br />t;thcr staSe re�ul'a!iuns as appropriate. <br />Company Narne: <br />Company Address: <br />Allspacs Muffler & E3ral<es <br />1004 5. Cherokee I.n.�fiA <br />Lodi, CA 95"l40 <br />Company Rep: <br />Ef�A ID # <br />Signature: <br />Mean I<hittt <br />CA1.000433443 <br />_ w <br />Phonr_ Number: 209-368-6888 Title: __��__ a e: ...__�._ <br />._.�_......__. 4�:� 1�..�3s�4:a�-.`e't'r:.�+`�� `�,i"irvi������:a �a�ieV:�i4''^�'I"Yi A� F-��i��1��i <br />._... <br />c�rner�i 4Vastc i?e;tripiion �Chtrmicai <br />C.nnstfiucnt, r'h, V�JTC..) <br />fiat. <br />Gass <br />kN <br />Lvaste <br />SCate� <br />Code <br />5�L <br />r1 Uf <br />Cnnt. <br />C�rnainerrota! <br />Type(Si<'.e <br />�A�asra � <br />(gal % ttj <br />Total bVastr� <br />(pnundsl <br />D'�sp <br />Meth <br />COSI <br />Metal Shavings <br />6.1 <br />5 <br />5 <br />40 lb. <br />$56.00 <br />0 <br />� <br />_r_ .__�.. .............._.�__.� _ _..__._._._._._ <br />. <br />....... ......_ <br />_._____..___ <br />._, <br />........ _._.__.._. <br />_._._�-_ <br />_... <br />,._ . <br />.... _ _ <br />_.._._.. _.. _.. __ <br />___ <br />_ <br />_ r <br />_.. <br />_ <br />�_ <br />_ <br />' <br />� 4� YA <br />P <br />___........ <br />.�-fly <br />"9.i ---3�.^�-w�S <br />-- ...�. <br />..__._ <br />AUS p� c <br />I� <br />—....___.......__ ___..___..._ .. .. <br />,_.... _ _. <br />_.._,..__.__.. <br />�..._ <br />.. _ . <br />_._..__ <br />_. _ <br />_... __......__�__..____.�T___ <br />. <br />._......._ <br />__.__. <br />� <br />1 <br />.___ _ <br />r r c7c� mE= t c �.� <br />� <br />_.._ <br />�. <br />� <br />__... _ <br />�`l_0 00 <br />.__.....T.._.. _ ._ _�. _...,, <br />t�c'.C15C1�i tJ� i�1(hrril�: c�sr1 <br />CheCK-tt <br />y <br />�% <br />��fj <br />—1.L/ <br />�__ <br />� <br />1r�`:r <br />''�7L �1� t�'diCl: <br />;�•%Ey.!•ila <br />St Nr a Yt I� t iiE r k In.�Qt� Infant Inch tl� <br />U,-� tai : 0��. _j. �! <br />L,l �-_-- - � -- �1 -- � __ . <br />