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m <br /> ,orator,Mail a copy to;-DTSC P.O.Sox 400 Sacramento,Ca.95812.040®within 30 days."r <br /> o.(Form designed for use on elite(112-pite11)twevniter,) Form A proved.OMB No.206Ci-Do3g <br /> ,RN1 HAZARDOUS 1,Genarafor ID Number 2.Page 1 of 3,Emergency Response Phone A.l lost Trading Number <br /> ,rBTEMANiFEST-- G�4C'd/g:��a��, - _ j — �-424= 1 <br /> 008043518 JJK <br /> 1era(o's Nsma arid Atailtrrp Addroo-$ �+ �7`�.P.tS 'r'/.) GenotaVs S€er Address(lt aitterur t it an rnai ng uddresay <br /> ' <br /> Gcna ators Ptuow <br /> 6. litiar <br /> Transporter 1 conpany NmttaI IL U.S,EFA!D tpraA <br /> Evergreen Environmental Services CA{7982413282 <br /> 1.Tranpoder:Company Nance U.S.EPA lD NunEbae <br /> S.Designated Facility Name and Site Address ENVIRONMENTAL <br /> U.S,EPA 10 Number <br /> Evergreen AV Inc. CAD980687418 <br /> 8880 Smith Ave. rx '7u•rC�nsar4ncnl-r <br /> Newark,Ca.94560 <br /> Fadi'a Phono <br /> ga, 91).U.S.DOT Description(Including Proper Shipping Name,Hazard Class,ID Number, 10,Containers V.Totai 12.Unit 13.Waste Codes <br /> HM and Packing G; <br />