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NOU 29 100 10:06 FR SK 718501 209 545 3680 TO 8241 20 - P.02 <br />fWT A%/rYw•LWY W.lYJVM/Jv l[Ypl/NY-JV-Yvl ---...... ....�•—�.. .. ..r a _Y ._, .�......._. <br />Plww Prnr pr ryp. /enn a'.,i0n.d fin w. a Jr f)S.pikhJ �Yp1YB S � Ol Sarem.nr. Cel:6rni9 <br />DISC 11022A w", <br />EPA I, W-,, <br />DO NOT WkiTE BELOW THIS LINE. <br />Wh1a; TSCF $ENOS THIS COPY EO OTSC WITHIN 30 DAYS. <br />.p. P.O. so. 2CC0. Sper•menr., CA OSS12 <br />%* TOTAL PRGE.02 'R* <br />UNIFORM HAZARDOUS <br />u D. <br />1. Grlaael. US EPA 10 No. Mad6•wmmrr W <br />• <br />2. P.R.P.R• In6mwd•n :n A..hanl •r.•e <br />Y.1 r•4yir•d b/ f.drl.I IM. <br />WASTE MANIFEST <br />C R 0 0 22 9 <br />et 1 <br />�. ft,',N«n.ond"ilinRAddr•,f ADVANCED INTERCONNECT TACH <br />555 CARNEGIE ST. <br />20532578 <br />S. SIa. Oaeaab/. ID <br />P. 0. BOX 952 <br />. Ph. I I CA 95336 <br />- <br />1 1 1 1 1 1 1 1 1 1 1 11 <br />!. irancpan.. 1 C9 -pal Nam• 6. US EFA ID Numb- <br />C. Sbb T ...P~. ID IR«wwd.l <br />f <br />3 0 0 5 5 1 <br />AFETY—KLEEN SYSTEMS, INCMOW <br />D. Tra.v.nKSM•n. <br />7. T,pn.Parr., 2 Ccmpa.r Wme a. us vA lO Numb- <br />L Swhi Traapsnw'. to FR pal 669 5 <br />1 <br />F, Tranrp9rra'. M. <br />9. De.igllald Facility Nay and Sr Addr.r. 10. US EPA ID Nymhrr <br />C'- S°w Fispl'n/. ID <br />718501 <br />TOODEi1 9 6 <br />w fp to;W, Ph.. <br />(SAFETY—KLEEN SYSTEMS, INC. <br />5050 SALIDA BLVD A 0 06113 6C45 <br />1014 <br />CA 41636812. <br />11. US DOT Eftwiprian lindydtng Prover Shipping Name. Hazard Oa.. ad ID Nums•rI <br />Canwin.r. <br />11 T9wl <br />Ouanrily <br />11 Un11 <br />Wc/w <br />I: w.A Numb.r <br />Na. <br />Tye. <br />a. <br />S1w <br />WASTE COMBUSTIBLE LIQQUID, N.O.S. <br />EPA! <br />PETROLEUM NAPHTHA) NA1993 PGIII ROA <br />DM <br />E <br />s•b <br />PA/ab-.c <br />R <br />I I <br />A <br />Srw <br />T <br />D <br />PA <br />R <br />I <br />.. <br />d. <br />Slam' <br />I <br />PA/OAer 1 <br />i <br />A. Addil:onal D•wipllan. for Wr.nal. Lind Abp.. <br />L M...duq Cady. 6r Wawe <br />Lirld A►wq r.., <br />IA) D018 D039 D040 <br />14 Ol <br />d. <br />j <br />IS. SP.u.I H.Mlinq In.rrv.u.nr..A Addai«rel Inlp ci i.. <br />I <br />MFST R/T#099582175 0002-0654-66 <br />EMERGENCY RESP 800-468-1760(24 HR). IF UNDELIVERABLE RETURN TO GENERATOR. <br />i <br />y •p.r .hl►pfnR noer•on RclpwFd. packd. <br />E6. GENERATOR'S CERTIFICATION: I h.nby d.d.n Apr A. nu or•f.IIF !/dacnb.d pbpn "'YE <br />mar6.a. pId labcled, and me in all nrpw. in pnP., cendlNan Ior gengwr W 6gh.oy •cmrdiriR b a <ahl. iM./naliad E wiipnd;.iq m«rl r• .6i. <br />I <br />d 19m a 6q• q'.nnly genmabr. 1 p.rl:f, Au I It.. a pragnm M p6.c. w nduc• IM cd m. and I.,iciry 9f wDo q— tp b A• d.gr•r I ha» d l..nPd w h. amaainll <br />• <br />and IPP. I I o,. rl•erd A.p 'nblr muted ..ff nwnmenr, pwpp, dcp•wl cyrr�lly —16166 P, m..hmh m . rM pr–. , a d hrwr. Y.r.pr b hymen I,= <br />l <br />pranicae4 <br />«: li. my a..r Y�'«ad Ial rte. b•.I wry. +.nag.nn..t m.Ihd Ihpl it <br />pnd rte• urv.e9nm.N; OR. if 1 o e .wwlI gyallry R•n•rawr. I h. rpd. a 0." 6�A .Ran `7,P` <br />a..dohu r m. and A.r ..n .Yard. <br />-I <br />Primed/Typed Na / <br />f` <br />SiRror <br />ry Tar <br />r l <br />1 <br />I l r.9n.p.mu I Achna.l.e wn r of g.cr al Awft".l. <br />i <br />I Pdnrd/iY <br />£pnarvn <br />Tar <br />i I S T•an, a : Achna–IM .-ver of t.c«m ei uaunah <br />j <br />,I <br />I nrinrd/T,a.a Nano <br />SigwNr. McnA Dry y <br />6 <br />(r' <br />)' <br />Oirn.cancy In j' p.'.n SFaa. <br />F <br />119 <br />c A <br />C <br />20. nacdiw O...n. a.O..mpr C«r,Fa�ien ei.xd rel hasardwr mound, ce..n yin ..aniMr an I a +ard w irm I9. <br />i Fnnlr,r,o.d sign. � <br />Y <br />D.Y` <br />� <br />tf <br />DISC 11022A w", <br />EPA I, W-,, <br />DO NOT WkiTE BELOW THIS LINE. <br />Wh1a; TSCF $ENOS THIS COPY EO OTSC WITHIN 30 DAYS. <br />.p. P.O. so. 2CC0. Sper•menr., CA OSS12 <br />%* TOTAL PRGE.02 'R* <br />