Laserfiche WebLink
JUN-057,95 VON 07 :41 AM PRC ENVIROPUR 209 892 2248 P. 03 <br /> •e`Caf beNims tiirenmeo- erorecd.n A"o See In=}rYatlOna an back of pe ocponmed of Toni.Suboencs Cannel <br /> A.Fre..rl py=W 4050.0099 IF..'..e A069q 4.e..mm1..C.hleeei. <br /> male P^.^or type. Fare,d<syn•d f.e..e on elle 7r4pRrkl type..dlll. <br /> 1. Generabi>U$EPA ID Na. Manifeef Document No. 2. Pogo 1 InForma6on in 16e shaded areas <br /> UNIFORM HAZARDOUSIs el required by Federal low. <br /> WASTE MAN[ STfCAq0j (ijtj6jq110 a 3 -7 3 of <br /> 7. G.neraloi s Na�meand MaiY:n9 Addrcn A. Stale Mantled Oaeumetd Numtw <br /> « � r ,-:; ' <;. .µ: 9 3 01$15 6 <br /> 83'7 8 wt f1 3twCivne ws 10 "1*-j• r';II : u.i! <br /> 1 24 n.13 CA 9;�� '.44 <br /> e. Cenerator�s Phone Fid 1 <br /> n S. Te.nf nor 1 Company Nome 6. US EPA ID Numbar G State Traneponor's ID <br /> Pay . .n• T.'.1 >'7�7" $14 <br /> F�frrRolaR <br /> o .+.-*••ter ncryrT r�'r�ap� �,� C A IT 10 8 0 0111110115 9 D'Tramrg�h° 2-8670 <br /> Q 7. Transporter 2 Company Name A. US EPA 10 Number E, Slab Yrmdponer'a ID <br /> J d ddI F. Trdneponees Phone•,. _ <br /> 9' �` �RbLFY}I "�lE`GQY��tYA( r`LfORP. i°, US EPA ID Number G state A'1D1D0 g 3 11161617'1.9 8 <br /> 13331 N. HIGHWAY 33 H. F.,liV6Phon<:.;:: t. <br /> PATTERSON, CA. 95363 ICAD 0 8 3 1 6 6 7 1118 1 (209)` •892-6742 ' ' - <br /> 12. CoMoinan 12. Tata] W. Unit ­;: . <br /> 11. US DOT Description(including Proper Shipping Nome,Hazard Civil,and ID Numbarl NO. Tylux 0..nt' WI/Vol E Wade Number <br /> x Dom,�., w,�-reR, .�r�r 2cais tJ•!r'2.3•.2�nut // 5iota <br /> G Wf}3!`7L F-•f &�. t-Ll l� DC)I r 7Tr0 U 0 C.S EPAT'7 .:-::• . <br /> � N b. _ <br /> � T C. <br /> — . 0 G FPA/Other,,; <br /> R <br /> d. Side <br /> V EPA/Other -• ' <br /> J. Addition]D.s.dptlons for Material,Unad Abw4 •i7r,;l: K, Handling Cedes for Wallis Used Above <br /> W .. ..., '.:a._ i� r )!re�;<i:irE''gre nV.e .1,•`�, , <br /> 15. Special Hondtng Innrucfiom old Additional Information <br /> 24 HOUR EMERGENCY CONTACT: PRC/ENVIROPUR (800) 874-4444 <br /> 24 HOUR EMERGENCY RESPONSE: CHEM TEL INC. (800) 255--3924 <br /> WEAR APPROPRIATE PROTECTIVE CLOTHING AND RESPIRATOR <br /> w 16. GENERATOR'S CERTIFICATIONi I hereby declare that if,.contents of the eens;9nentra are fully and accuraMly d...6bed above by proper shlpping name and are el."ifiad, <br /> packed,marked,and labeled,and are in all respecn in proper condition loo trontport by hlghway'occording to appl]eWs Nderal,rlala and inlemolional taws. <br /> If 1 am a large quantity 9....ow, I certify that 1 hove a program to plane to reduce the,alum.and toxicity of wane generated 1a the degree I how de.mrined la be <br /> 0. economically proaimble and that I hoes selected the praniceble method of heofinenl,narag.,or dhposol currently.1.61.to in.which minimires the present and Iumo <br /> yl Mnot tg humors heellh .nd the eadranment;OR, R 1 ono o..It quan%ry,genermar,I he"made a goad failh effort to minimise my wasl. generallon and..led the ba=t <br /> wane mono em rrt method that I,available to ms and that I an afford, r <br /> Printed/Typed Nome Sl9n rel Moeh Day Year <br /> �/ ✓ d r 3 c� 19 <br /> s17, Trans once 1 Acknowled em.nt of Race 1 of Mdrerials <br /> ur & Prime d/T ed Nome <br /> YP Signature Month Day It.., <br /> a 18. Trans over 2 Acknowledgement of Receipt of Motor b <br /> ji Prinl.d/Typed Nome SigJraNre , Month Day Year <br /> e <br /> ' 19. Dhaeponir Indication Space <br /> F � <br /> Owner or erator Ceriifieofian a(Fe<e r of 6mrr)nu.mated "red 6 Air M064,11exec t m nnled 114 19, <br /> Printed/?,,.d Nom. <br /> signature Month Y OaY Year <br /> DO NOT�W ITE B'ELO THIS LINE. <br /> )TSG 6022A (7/92) <br />