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Jan 04 2019 11:1OAM Dave Robinson 209-751-2157 page 4 <br /> { <br /> Ple �eplirlf or typ6. f Form Approved OFA 0.205+)(Ia39 <br /> UMFFmRM HIIARDOUS 1.Ganerapx ID Number T.Page i.af 3.Ernafpency Response Phone 4 Nest TrscWng Number <br /> WT ,; FIF ST c 3Wj� g1&sr1-wr 0191 '74093 JJK <br /> S:.Q6netp}nr¢Nenie End M piling Address Generel3r s Sile Address(f c1ftera than mailing address) <br /> OIIJAWY FL.EE"r'$EF%4Ct-,1 GENT ER <br /> 5 AIRPORT WAY <br /> STtSt:KTt 11U,SGA. 95205 <br /> Genaratork Plan - j <br /> 6.Transporter t Corrhoany Name U.S.EPA S5 Number <br /> R��;e EiV'tAFICIAF3�IENTKt.. 4:+Frrtr'I��MlC:. •' <br /> 7.7 spotter 2 Company Name CADfJi 4W*38 � <br /> U.S.EPA ID Number <br /> rt �4oti S I <br /> 8.Designated Facility Name and Site Address li;Et t1-}A ES TECHN) aL lr4C1L LfiMq U.S.EPA ID Number <br /> IZ HENSLKY OR—MET 0A!Ol3iAOIA074 <br /> R"?uIOM.CA W71 <br /> Faclil s Phone:800' 45-2W <br /> 9a, 9b.U.S.DOT Desc ipton(including Proper ShlWirg Name,Hazard Class,ID Number, 10.Containers <br /> HM and PacKhg Group(k any)) 11. t Nd.Unit <br /> No, Type tluank 13.Waste lodesitflyr Wt <br /> WT7, WAWE EOARLIf+IP►3ENPALLY KV-ARDfJ1Ll5i -SUBSTAkES P ttil CJ17,7? <br /> IJD7 Ft!DS. :a,P131H (BRAKE! S`ttc�i WGS,CHR()&WR E''%C <br /> 3. , <br /> 4. <br /> :h <br /> 14.Special Har ang Instrur*ons and Addit W lnbTndon <br /> 9e-1)l GF11E EftSx i t <br /> E 1•F. I�C�3'i'FtAc:TCIR t�Afa9{�S V1�Rfd1vlarRfTAL <br /> HA,MLEVS SHOLILD FE TRADED APpJ U&E AFfiFtoVea pPE v' <br /> 9 61=1 <br /> 15. QENERATORBIMEROK8 CERTIFICATM,I heret:y declare that the contents of this oonsigrment are fuVY and accurataty daso-W above by the proper shk)pFg rmme,and we classified,0dooged, <br /> e :marked and labeledf placarded,and nein a'roapeetsin proper condidonlor hmappm scoording to appncable Intema4onal and nedona govemmenbd ragulayorq,N e>W shipment and I am the Rnmary <br /> Exparl3ar'f ber*that the conlerifs of this consonant ionfarm to ete terms of the attached EPA Admowledgment of Consent <br /> ;;. F r�rffial 8'waste'inirMmizeBon statenhentidAntiGed-in:40GFR 282.21(re)Qf I sn a. n 9�>Irb'7enerabr)'�jb)(ttl:amp mgil.quanefy 9aharaMr Aibba:. .. <br /> -0- <br /> ; rots 1P,*i�dtT <br /> ,. ` 1W Yaw. <br /> 16.Inteftbonil <br /> �hnpod b U.S. t od from U4 Y+rOrtDFaIIY�FaiIIE' <br /> Transporter signo"lure(for ex"only): <br /> 17.TransporiKAdvawledgrt>ant of Recefptof M*rials <br /> f Transporter 1 Printed <br /> Year <br /> A ah <br /> Transporter 2P4r - yped Narne <br /> Marsh NY Year <br /> 0 3J 114 t <br /> 18.Ot"ancy <br /> 18a DbcrepanOy Ihdloetipn Sprue ❑ i <br /> ,r Qwnlll} Q T rpe ReSidun. Partial Re)ectlon �Fu1 Re�Wm1 <br /> 18b.Altemata F. ManifeatReferenca Number. <br /> r acilty(or Genmrtor) U.S.EPA ID Nurnbor <br /> LL Fadlity's Phone: <br /> r� 18a Sig Wk"of XG-nate Facility(or Generator) ay <br /> YW <br /> 19.Hazardous Waste Report Management Method Codes{i:a.,codes for hazardous waste beaenent,dhpoaei,and recyding ayaiwns) <br /> G t' 2, <br /> FM sigroleAfecd' bamergrl?pOfMAr,Certltxxationcfracelptrr#haa#rAode•m adtranldbythe?olhele>mtipt+MndsdinQearlBe <br /> n alts <br /> hJr MM LW. YM <br /> ! <br /> Of <br /> 11 V <br /> EPA Form 9 (Rev.12-17) Previous editlons are obso4l!e. FA <br /> , UTYTd GENMAVOR <br /> • - 'q <br />