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BEFORE COPYING FORM, ATTACH SI',- IDENTIFICATION LABEL <br />OR ENTER <br />SITE NAME Atchison, Topeka 6 Santa Fe RR CO <br />EPA ID No. (c I�I�1 qi �i J�I SI`�LR 1414 <br />OMB/ 2054-0021 Expires 3-31.92 <br />ties <br />A ~ U.S. ENVIRONMENTAL <br />PROTECTION AGENCY <br />1989 Hazardous Waste Report <br />FORM IDENTIFICATION AND <br />CERTIFICATION <br />INSTRUCTIONS: Read the detailed instructions beginning on page 7 of the 1989 Hazardous Waste Re klet before com this form. <br />E -- - - <br />SEC. I <br />Site name and location address. Complete Items A through H. Check the box © in Items A, B. 0, E, F, G, and H if same u label; If <br />A. Please pnM: Last name First name M.I. <br />different, enter corrections. If label is absent, enter information. Instruction page 7. <br />A SwmEPA <br />too. ` / <br />Same iabet <br />e. Sarno W Wy PERMIT/SERVICES <br />s.m. IabN <br />s <br />as or ---� ( I I I I l_ 1 t I I I I I <br />as <br />as a <br />C. Has the she name associated with this EPA 10 changed since 19677 ❑ 1 Yes <br />$ No <br />0. Street name and number. 9 mm applicable, enter Innddursttriiaall park, building name of other physicN Iorc bn dexripbn. <br />Una as {abet ❑ <br />or h��7�a/'Y /7/�Y 1457-Yy 0 <br />y <br />E. City, town, �inags, etc. <br />f. CouMY <br />0. State <br />H. Zip Coda <br />UT* ast.bel 0 S�aTo <br />541"* as taw 13 <br />s.m. as WW oor 0 <br />Mailing address of site. Instruction page 7. <br />ling address the same as the location address? ❑ 1 Yes I WP TO SEC. ■ 1 <br />Z No (COMPLETE SEC. 1) <br />FItftl. <br />nd street name of making address <br />5770 South Eastern Avenue <br />vi0age, sk. <br />a 9We <br />E. Zip CoOe <br />Los Angeles <br />ca <br />I 1 I <br />9 0 0 4 0 <br />1 1 1 1 1 1-1 1 1 1 I <br />SEC. III <br />Name, title, and telephone number of the person who should be contacted if questions arise regarding this report. Instruction page 7, <br />A. Please pnM: Last name First name M.I. <br />S. Title ! tandge r- <br />C Telephone <br />activities of the site. Instruction page 8. <br />Environment <br />1 21 11 31 1 8, 8i 91- 17 17 16 19 1 <br />Clark David C. <br />a N A <br />L1_1_1_J <br />e.Please "'CLArK' �''"""1e DAVID C. M.i. <br />R <br />cManaaer-Environment <br />D. Signature <br />Extension L-A I 1 I <br />SEC, N <br />Enter the Standard Industrial Classification (SIC) Code that describes the principal products, group of products, produced or distributed, or <br />the services rendered at the site's physical location. Enter more than one SIC Code only Ono one industry description Includes the combined <br />pNumbI <br />activities of the site. Instruction page 8. <br />A. 4 0 1 3 <br />I I 1 I j <br />s. 4 0 1 1 <br />1 I I I I <br />a N A <br />I 1 I 1 I <br />a N A <br />L1_1_1_J <br />Page t of 4 - <br />EPA <br />EPA Form 8700.13A/B (5.80) (Revised 11-85) (Revised 12-87) (Revised 11-89) OVER —> <br />certify under penalty of law that I have personalty examined and am familiar with the information submitted in this and all attached <br />documents,and that based on my inquiry of those individuals immediately responsible for obtaining the Information, I believe that thesubmitted <br />pNumbI <br />information is true, accurate, and complete. I am aware that there are significant penalties for submitting false Information, Including <br />the ssibili of fine and im risonment, <br />efor form pages submitted <br />Foran IC 1 I it I Form GM 1 1 19 Form WR IIA Form I I <br />PS I I <br />e.Please "'CLArK' �''"""1e DAVID C. M.i. <br />R <br />cManaaer-Environment <br />D. Signature <br />E. Ogle of signature (�+f, (''�, _� , V Li <br />�Mo. <br />DAY YR <br />Page t of 4 - <br />EPA <br />EPA Form 8700.13A/B (5.80) (Revised 11-85) (Revised 12-87) (Revised 11-89) OVER —> <br />