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NG_ . HAZARDOUS WASTE:.MANST <br /> Please print or type"' {Form designed for use on able(12 pitch)typewriter) - - 2.Page.i - - <br /> 7.Generatoes-US-EPAID No Mar 4739-3 x7393 <br /> NON-HAZARDQUS .;' _ DocumantNv. <br /> WASTE MANIFEST R <br /> 3.Generatoes Name and Mailing Address <br /> f3:ed.y Stern ��ocrxs Atte: Pat Gaill ty <br /> 5200 : ,eila Street, : Crerce; '.CA. I. <br /> 9(3�J4�3.. <br /> 4.Generator's Phone{. : ;-254-5200 <br /> 5.Transporter 1 Company Name_ - A.USZPA ID Number`s A.StateTransporter's <br /> .. -. nsporte <br /> -' B:Ira r.i Phone <br /> MAIL Try - <br /> 7.7ranspo Transporter Company Name US EPA 10 Number C:State,Transporters ID <br /> - -, - - D.Transporter Phone_ <br /> II to: EPA ID Number E.State Facilitys 10 <br /> 9.Designated Facility Name and Site Address <br /> enedy �Yivirarhental <br /> F.Facility's Phone <br /> 320a.'.E <br /> Fmntera -Street <br /> . ;12' Containers,: <br /> 13. 14- <br /> 11 NlASTE DESCRIPTIDN `.. Total Unit <br /> ... -- '• 'No.. Type - <br /> Quantity <br /> HA?rA' OLT YTAS'J' ' <br /> LIQUIDS <br /> {a b. <br /> E,. .77 <br /> R <br /> A _ <br /> R. d <br /> - -- H_Handling Codes for Wastes listed Above , <br /> .G.Additional Descriptions fof Matenals listed Above - - - <br /> Ik a,) 06 <br /> zari3ous <br /> .. <br /> PROFIT #€�4-I�" <br /> p D QN <br /> Special Handling Instructions and Addoonal Informahon -Job Site: StDCKtOn �'acil'c-X - <br /> 7 990 piecol�.`std <br /> ' <br /> COVES .& Gal='_ S itton, CA 95215 <br /> # <br /> Willy AW <br /> .16.GENERATOR'S CERTIFlCATION:i hereby cettiy that the concerns of this shipment are fullyy'and accurately desdnbed and are in respects - <br /> -- in pioper:cgg4 ion for transport.The matenatgdescribed-ontfi'rs manifest are not subject to lederal hazardous waste regulations -- <br /> - <br /> Sg , ,Month ':.Day, ''Year. <br /> PnntedrTyod Nama <br /> ow.,`.'...� <br /> Da_to _ .. <br /> T 17rTransparter't Acknvwtedgement of Feceipl of Maten <br /> als <br /> a year. <br /> R u, <br /> Month.:' D <br /> A- P <br /> We Name <br /> Ss n <br /> 9 3 y <br /> " :� G <br /> O Date <br /> 16 Transporter 2 Ackno edgement of Receipt of Matenals <br /> RL <br /> P.nnted/Typed Name S gnature <br /> T, ... .'. . „ <br /> :. <br /> _ _ - _; ' -'• Month- Day .Year <br /> -14•Discrepancy Indication Space - <br /> A <br /> 20.Facility Owner or Cperaldr;Cerhticahop of receipCq!the waste ma[enals'covered by,this marufe5! except as noted m item 19 <br /> Date. <br /> ' PrintedlTyped Name 5+gnature Monih,,: Day ".Year <br />