Laserfiche WebLink
0 0 <br />=i 4 <br />Plaasn,n(n1 nr l�oa 1en,m Anemned lnnma „�oee nz�usa u,,,,•,..aan <br />1)14941/190135' rU1:bIUNATEU FACILITY 7O GENERATOR STATE (IF REQUIRED' <br />3r. <br />A <br />,; <br />nn ny..arou. vino nu [ "'U'u0 u <br />1. Ganam2c lD Numanar 2Pe of or 3. Emm erc Res ansa PMno 4. Manlfant Trackln Numbor <br />UNIFORM HAZARDOUS g g Y B <br />(`O11s'eR?`iY5':011 <br />WASTE MANIFEST <br />1 ,- 0,31 - Ai-,II - FL <br />5. GenmaWrs Hama and hiaa4ng Address Genomals She Address (y diHerenl Than meilng address) <br />(4114V!?rRgI1P ]NI': <br />17000 F Ht4V INA <br />R 1 PON <br />Gmaleurs Plano: 2Y19":i j'_i - I1 I i <br />. Vansepinda, I Company Nam , U.S. EPA ID Number <br />:IAFETY-14LEEN 9Y�JVPM' 114l"i <br />Y., :rOlQls?1pl?Y•, •,eq, <br />7.TranspoAe:2Company Nama U.S. EPA ID Numbar <br />B. DesigneledfadldyNano and Silo Ad dims SAFETY•-KLEEN BYS?'[:dt=i, IMC. L�,MIDNumbar <br />6000 98TH 91-RErT <br />SACRAMENTO CP 95628 <br />FadtyS Phone . 9113 -X%6 -4''J i.i [;A0000Tg4:�1 / <br />go, <br />9b. U.S. DOT Desmprwn(mckidingPleleir 54plml Name, Henn) Clan, ID Number. <br />1O. Conla0me <br />11, Taal <br />12. Unit <br />TIM <br />nrid Packing Group (if my)) <br />Company, <br />wlNol. <br />13.WmWCod1 <br />No. <br />Type <br />rc <br />1'NL]N--RCRA HAZARDOUS WASTE, I-MIJID <br />UM <br />f <br />134 <br />a <br />(AG!IJIMILIS PARTS WASHER SOLATION) <br />z <br />W <br />2. <br />tD <br />3 <br />1d. Spedal Hantllmg lmirucliana and Adtl9bnal Information 9K 8H1P#cQa044•4a@� ,371458 C 5G: <br />203 iD7f73 <br />EEN - CONTRACT #94.1.38) <br />E4 HR EMERGENCY dli-,D00- 17(10 (SAFETY-KLsi <br />75. GENERATOR'fiIOPFERCRS CERTIFICATION: Ihembytladem Bwllhaconlenlsafihla mnaignmanlare hllyandemsrMelydasaibed ebore by Oe peopaahipping name. andamdMiged, picIdgml. <br />madasdmrd Iabeadpkicallod,and Brain all IMMIa lnpmparmndition lorbmwponoxaMng weppdcablolnlanodOnol Bed Iwdadel gov minIM"fDns. Ilesponnhlpnsmmnnd lemurs candy <br />Esrysb!r.l canly Bol the mnlonU of mb mnsignmem mnloml to No terms olBw oged ed EPAAcknawledgmmll of Consnnl. <br />I ead7y dw1Ow meta disinflation slelomenl61and8nd In 4O CFR 20227M(dlmn alarge comedy gawmtor)orfe)[a lam as BWanthy9onombr)O1ye. " <br />doral a a% o oma Ila my our <br />b/� <br />L7�= <br />FJ- <br />I6. nlBr 1' a15Rpmonfs <br />❑ImpMto U.S ❑F iron U.S. Pmlofan <br />z <br />— <br />Pan axil: <br />Transporter aluminum lix soundswWyDBw lsavil U.S.: <br />fK <br />I1.TmnspalerAWwModgmml of Receipt ofMmados <br />sY <br />Tmnposleti Mmicarlypoor Nam bkjnokVo �...— any oar <br />- <br />' <br />T lwpodar2P emirSignature <br />>ry oar <br />.{ <br />18.1%saepanry .• <br />180. Discrepancy Indication Spina ID �Bnd y ❑Typo ❑Roddue Dander R1111ion ❑FWIRe)actise <br />Mmllfnl Roleranca Na111baC <br />Iub.Ailensala FedNy (m Gmpaala) <br />7 <br />U.S. EPA ID Number <br />U <br />LL <br />d� <br />Fadfi BPhona: <br />IBc nalmeolABemals Facility (or Gerarala) Maeb Cay Year <br />T <br />HIB. <br />Hazardous Main Roper! elonagumtMotAod Codas i(s„codes fw11Mldouswaste bealmanl, disposal, and recycling B"wervs) <br />0 <br />1. H141 2 3. 4. <br />20.OnsignakdNFaamWa�ry)Owrwrar Oparabr: CeNfiggon ofmmcAdhawalruemaledals manned by Me menBas!c. pl led N Ilem 79a <br />ar <br />P //`J' <br />aDey <br />EPA Fnrm <br />R7nnd9 me„ <br />1)14941/190135' rU1:bIUNATEU FACILITY 7O GENERATOR STATE (IF REQUIRED' <br />3r. <br />A <br />,; <br />