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04/11/2007 16:58 5106709904 FILTER RECYCLING PAGE 02 <br /> Nl7!!•NA2ARDOUS 1.na,,,n1w ID NumOer 2 Pegg 7 U 3.P1,ergeryy Fleaporlse Phone o.waste Yrxahg Num'6er-— <br /> WAM MANIFEST 7 909-721-2MB 34019 <br /> 5.t ACY &lig Addnae eeneroWs She Admeea(a deem Mai mating ar,vesa) <br /> 1875 W.LoWeg Ave 315 E 17th Street <br /> Tracy,CA 95376 Tracy,CA 95276 <br /> Gxrenmre PM,6; 530.662-2841 <br /> 6,Thlyd ner 1 Company Name U.S.EPA ID NUVW <br /> Fuer Recycling Services,Inc. C-AD982444481 <br /> T TrSMOW 2 G,mpa,p Name - U.S.EPA 0 N1 mW <br /> 5• MAIL 4,dlaR;b .... U.S.EPA ID Wft" <br /> 180 W MONTE AVE CAD962444481 <br /> BLOOMINGTON,CA 52310 <br /> 909.421-2012 <br /> Pm •a Ptgne: <br /> 9,Weam SnkMOB Name and DeecdpllOn <br /> 70,C4ndw11.Total 12 Una <br /> Ne. Type Oralk WLNot <br /> C) <br /> r <br /> 113gaNN11nasagg <br /> 2.'k MsmowsanM ry e#0703'1320 Wear rAppropriate PPE Invoice tf39D19 BIp to Della Oil <br /> 1d.GENERATORS CERMCATI0N:I Wily Te maww"dercdaad aaove an memres ere Ml e,eia gderal+eguluons for npa0r.g po a dlBpoeel Of Flewn"Wads. <br /> �tfews ProodIrry Name a7.�. SlgnaNre MWM C1m/ Y6ar <br /> UG,,y n �_ 3 /5 C7 <br /> F i5.l0wi1bnal SNM ntl �� <br /> E ❑5npen m US. ❑Eepat hom .S Pon of entry/erN: <br /> TWn0b1 Sonalure Corea arm Cate lBevl U.S.: <br /> C 16.Traespmmr AcanoYAedgment of Rec*at Mamrgtr <br /> Treneporle I ftw y*Nam, 5 VWM Day year <br /> z �--- 1 3 1 is 10-7 <br /> z TnnSWW 2 PMeCyped Name Sign Main Ray Year <br /> 117 Dwspancy -- <br /> 1%MwnK cy IMlevam Space ❑carom ❑Type Cl Poaitlue ❑Pe u rlaJecden ❑FW Ralae6an <br /> Manlmet Palare ce Namear: <br /> '., 17E.AaBPIe1B FKRty(Or Ceanamlar) U.S.EPA 10 NUnl,er <br /> q f 'B Phone: <br /> F 17t Spanwe of AMmine Pecaly for Cw"ar) �— UMor,h Day YW <br /> a <br /> s� .v A's t .✓ p r d k^wi L a< P4Y:tAl1 + t <br /> x <br /> 16.Deslynatsa Faatiry or Operata;Conlicadinne resp[at mamdnts Mwed by Rs mantes+emept a Mud In Item 17a <br /> PMW*7VM Nem Slgnaeve mamt, /Ory year <br /> -3 1 <br /> 16"l-C-05 11977(Rev_&06) DESIGNATED FACILITY TO GENERATOR <br />