Laserfiche WebLink
Flo se pdnl or type,(Form u Am Form Approved.vivo,........... <br /> _ <br /> UNIFORMHAZARDDU6 t.Oenme!orlD Numbv 2.Peen 1 of 7.Emergency Rasponea Plane dntreat Trac ng Number <br /> WASTE MANIFEST CAD900737225 500-424-9300 0 04907596 JJ K <br /> 6,GoWMBUMAp9Mn eliminators Slid Addmes(II dl4emrt 1400 th lling addleas) <br /> 1240 NAVY DRIVE <br /> ST009-FON,CA ,5296 <br /> Generales Prime 2A9-460'3903 <br /> 5.Tn"u pormr I Compony,Neaa N.S.EPAID Numbs, <br /> EVERGREEN ENVIRONMENTAL SERVICES CAOM112413262 <br /> 7.Tramp der 2 Company Nemo U.S.EPA ID Number <br /> 6.0e li r ' -I�, n "16 AM= U.S.FPA ID Number <br /> 6Sa0 SMFiH AVE CA17980Sfi7419 <br /> NEWARK,CA 94SO <br /> s1a�5s 44aD <br /> Fedlll et Phone: <br /> ge So.U.S,DDT Dewrpdon(ncludep Pmpar Shipping Name.Natant Claes,ID Number, 10.Gdnlelnars 11.ToW1 12,Unit <br /> 13.Waam Ctdlaa <br /> HM antl Poeldrm Gtodp fll any)) No. Type Guanllry WWoI. <br /> ! � �`A <br /> � C�6z 75 <br /> 3. <br /> 4, <br /> 14,spi—cmi;ending urvallo send gddadraal lMaMlaWn <br /> PROFILE� /3 ERG 7 DRUM SIZE:�+ <br /> 15. GENERATOR'SIGFFERGR'SCERTIFICATION: INmby dodme!nm the arias at this condimmantan(uhyam accurately described GWV6 by the proper shlppl4A name,and are changed,pecespua. <br /> marded and labegdlpmearred,end aro in all imposter In proper mrdlllon for useral among to aeon le Internallonal Bile national easement negdaeera,II exponehimment and I em the Primary <br /> Expand,I clarify mel mo contents Nmia rnmigmrlem mnmrm to the Isms of No etlacned EPAMIntowidgm ent of Consent <br /> I cmd6'that the addle minimization Nemminlldenllpad in 40 CFR 262.27(0)Ill-m a tape quanely nonerallso at vriam-well q"ityg-mralor)Is two. <br /> Genamrorsloperors PnmaaRyped l/eme -� Slgmiu Monty Day Year <br /> 16.International shipmentsIf 1'2�ow <br /> F-aLjlmpcdwvs, El Erman from U.S. Pql afemry/axle: <br /> a Transporter agnawre(larexpora cnlyl: Damm-Ping U.S,: <br /> 11.TrandporderAcItammetimmint of Racer of Mekmis <br /> Clmnspmer1;PIO&ITyped Name, Sign mare44 Mo� Day_ OYd+ <br /> a /1 /W <br /> y2d. Trarz or 2 PnnwdRyped Nemo S' Mo Midnight Gey Year <br /> 16,Dlecrep-dry <br /> Its.Discupondy mdlcallon Space ❑ Gaudily ❑Type Diastase ❑pamef Rw,diri El Pull Repelled <br /> MaMlegl Relamrma Number. <br /> 18b.Manners Roughly for Genmewr) U.S.EPAID Number <br /> L1 <br /> LL Facpiys phone: <br /> W 16c.Signature of Alternate Facgpy larGenerator) Month Day Yew <br /> N <br /> 19.Hatmeous Waco Report Management Mallod Codes his,codec bar haedode waim treatment,disposal.and recychrm systems) <br /> 20.Dedlgnemd Faulry Owner or op enter Caturmdm at receipt of hazardous mammas covered ray ms manifest except as road In land lea <br /> PrnfloaRYperl Name�. elgnar Morin Day Year <br /> 1(95 a, o <br /> EPA Form 670C•Z2(Rev.7.05) ProviouskiJitions are obsolete. NATED FACILITY TO DESTINATION STATE(IF REQUIRED; <br />