Laserfiche WebLink
06/17/2009 10: 30 5105811102 JACK EDWARDS PAGE 01/03 <br /> !iWh of California—EnWrormehibl Pro4eckiM A"rfcy <br /> Farm AP rftFV4 OM4 NJ.111050-001P(expires 9,10-90) See Instructions on back of page 6. Drportrmnl of To.ir 3abilancni C6henA <br /> 'P.I ale 5114"r 1�pn, Farm dmfghed for ago oft Afo(12-pfkhJ ityptowrilor, 7.17,285 Simmmmnlo,Callfarnfo <br /> UNIFORM HAZARDOUS 1. &nvotor's US VA 10 No. Manifest Docufflomf Na. 2. Page1 Iriformolion in fho lhmdod hfo.5 <br /> is not required by 6�� <br /> WASTE MANIF95T <br /> — C 1113111��1�10 11. 11. R 11. 14 - I — low. <br /> - <br /> 3. Generator's Nomp and MaIll"Address A. State Manifest Document Number M <br /> 1111M.IT, OTT. T-T("M-5 ull$ 130041011 25295691 <br /> o t. 700 NOMME"(AIM-IMTVF GOPOrntor'sn 11) <br /> , <br /> A, Pheno[4(X),r0tjI4 'M 771M7 i 2AA 874-22-38 tF 1-3 16 IO-J.5 19 •7 !3 .I- <br /> r`4 S. Trontporlerr I Company Neale 6, US EPA ID MinihAr C. Slc0 Tnewsparlor'i ID(Reitryo <br /> LO <br /> r <br /> 1P , (i 14 1474 1.1 12 —1). Trrlhspdr*?z Phone <br /> 8 r`1-',M111RV <br /> 00 <br /> -1, 7, Trvffsp%ir*7 Company Name S. US EPA ID Mu.[Kr 8,'Slat,Tmmparlor.'%ID Ittaxervad.) <br /> I-S�L-T elF-rj — <br /> �-4Lk <br /> 9, NOgnaled I'mitily Name oml Slit,Address i b. US EPA ID Number G. W16 FOCIlivs to <br /> r11Rll)-VM114 VM"110MIMTAI, M' .., ---,-L-J—J—I. <br /> 2.024�i K patility't Phan" <br /> ly <br /> 19 Tolo 1 d, Un; <br /> I I US DOT Description fimelAng l"Phor"ShIpping Name,Hazard Clmt,end ID Nfjaiher� 12. Contciners <br /> U 0. f4,- -> n 1. Woal*Number <br /> I TyPM <br /> z a Stahl <br /> EPA1016ot <br /> 'Slat* <br /> E <br /> P FTA/01hrf <br /> A <br /> T UIN(-,OUN- State <br /> 10 S�,N j0p,0 <br /> 00 0 <br /> R <br /> 01Mr-ALTH ME <br /> sv d. V ROM <br /> Ml <br /> V <br /> J. Addh;orai 0hictipfforli fee Mdla;als thled,AIM)Vb K. Hal,14ig Co4w loo Wdslbi luted Above <br /> --,AqM901W, A9,1007 lths.i OR <br /> LU 'IT-AM11F)TIM vim rAsoun (mg .- IBNR? jM(,j.j (q <br /> z 15, Spoclol KelmMinil Iminrctiens and Addltlunal Infofmolter <br /> M5 M f3MIM ONX lin, 7MY, CA, P.0 ATMA NMI <br /> ,tip <br /> LU Z,) <br /> sr"'0541931 <br /> 16. OttsilthATORIS CERTIFICATION; I komhr dttlam that tko contents of Ibis can sigaMent are folly and mmvraiily d4scrilngo ob"n by proper thip <br /> marked,and lalmlacl,and orn in all telponcit In proper candlilan for imnspeln k y Hrnhwny vtcarding(c,oppllco6le Immmelloinol and mg-ilal;oni. ti <br /> It I Mfn 0 Ifirtio q(0001annitralar,I cerll�that I have 0 program in plore to r�idijco the Ychimn and toxicity of wosla ganoraled to thti degree I kava determined to baeconomit 11 <br /> proellcalsla and that f a loll-cled the proclitu8la method a Frealfell4ml,slortige,or djorAsml cmrnlly cnoiloble to we which mininnizat the prbsenl and luturo threat to lwman health <br /> rd 1111�nMv;ranmffnF;OR,If t am a%mall quanjil oem*rolor,I kt%vei mee4b*good tahli,effort 10 minimize "it.00—atioi and infect Ilia 6osl waste mandfl—I mnihocl 1601 is <br /> avell1a6la to m.and Thal I can of6,J- <br /> 0 7 <br /> Prinl,,J/Typed NdM* 'x}11,.4.t r-r- Meath D" Y.dne <br /> (.9T 17. Trane inter I At6owlecilgemenl!of Racal pl of M.lnd.l, –7 <br /> cc! I PrlmlryJ/TyrKwl Noin <br /> LL) no/ —M—IM111 D" yow <br /> w. 0 .10. Trans parior"JAdmuwIndgr l6fRoceiplo[Moloriols <br /> 0 R <br /> tu 1! Pom /typed Name Moril, Dfty YAMF <br /> F itason Spoto <br /> A <br /> C <br /> 20. Fu0ily Owner ora rotor Cartificcolorl of—eloteff li-tdrd-ut maInflallcoynro9d tYy flikm ohifait nxcnp.1 as eelnd In Ilam 19, <br /> T Milmd/Typod Nqmo f0h any Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> ENTVSFt) Yellow. TZF SENDS THIS COPY 1`0 IGENIERATM WITHIN 30 DAY,$, <br /> DISC 0027A f1/991 lGimeratort w�b subiniii hnrerdaf`a5 Wailt, Fe,ltari5potl ovial-iffalin. <br /> EPA VCO—)7, L protlocr corinplAl"o co14&1,tpy and lead"tC,_NSC W;,6iL"Io d.r1j <br /> 2'ALI{,M j <br />