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NON HAZARDOUS. 1 Generator ID Number r 2 Page, of S.Emergency Response Phone 4 Waste-Tracking Number' <br /> WASTE MANIFEST f xE V1)''P r r 1 3,t# t;, � r�3r ) r"2 f l i'" F .1" . +? ' �')f!3, <br /> �. S,Generatoess Name and Mailing Addres�s,.sq! !n,•, Att 4WS N(�k E{`^t44;.VoCi�?'Genbratyors[Sines Address I dllerenilltthlih'mailinhg ay�ddre�s^sf)i p px` 'y .a <br /> CAL1'RA'5 i`oT•t-1 i TtJ/ �4r f+{bLT1 Q c1 Edi�1 STf gi Rv f�l`�i 41kY"1T7;«E <br /> .416 E.ST GIr3fELC�r�:AV2,5 IAM ikt!} �: 1�����U�� � ��'. ° <br /> q ""6- <br /> 6. <br /> FRESTO 'CA 931,326f -5TOCKPOIN CA <br /> t"!1' '+ r .`5:•t q <br /> I: Generator's Phone: :. <br /> I' 6.Transporter 1 Company Name_ U.S-EPA ID Number <br /> N .ENi ir4omirx,r5\ire, GERI p •' {� <br /> tt 1 ,�_i54:.- Y+�,s M 6i i�i`.. •• � :°�,,..,�•: � (.� t.�. S,F Q 'r�+� i:f '� 1 <br /> 1 � <br /> 7,Transporter 2 Company tJame •, ``" � ", `U.S.EPA ID Number <br /> 9..0 'grated aq'lily Na a and SlteAc(dress U.S EPA ID Number <br /> r <br /> f <br /> FacilitYs Phone: <br /> 10.Containers <br /> 9.Waste Shipping Name and QescAphon 1i Totai 12.Unf1''` D•. <br /> , No. Typa' quantity WlNoi. <br /> a LU 2. <br /> 3• k <br /> 4 <br /> ' <br /> 13,Special Harding Instructions and Additional Information o T <br /> tJEr�Rr!� ` CI'E2"rIl' `?�ltxItu "fCri`dSa'ifiSTriltl #r' r `£ E(fP3i?r� h1r1fr1 ". k#fa `-1�c � 5k <br /> d';`j►i�{)[r ;1j 4 i3 CvTUUL %KIM 1w, 31vo w VA??Lz F3 S ",e«"r�7 °' 61^atlt Lt4 I$'D 3 T+�SLT4=rCiS r t <br /> ASfi}3 <br /> 14.GENERATOR'S/OFFEROR'S CERTIFICATION:I hereby declare that the content§of this consignment'ate fully and accurately described aboVe by the proper shipping name,and'are classified packaged, <br /> r marked and labeled/placarded,and are in all respects-in propel conddion(or trarispoit acconiing to applicable International amend netional governmental regulations: <br /> G�enerator <br /> roi1`af ..(N'rrmIey / . r / 'M <br /> 7th a ar/Off ' il�yd o <br /> 4 ?i 6 , <br /> r 7 s <br /> a 15.International Shipments f '"^r'' <br /> 0 Import to U.S. ExportlremS.., Port of 13ntrylexft <br /> Transporter Signature fore its onl Date laavi U.S <br /> LU <br /> 16.Transporter Acknowledgment of Receipt of Materials' <br /> t Year SDa¢ Transporter 1 PrintedirTyped <br /> t <br /> a Transporter 2 PrinledffypedName Signa(ure'i� b / Month DayMonth <br /> Year i <br /> i ,17.Discrepancy <br /> -17a.Discrepancy indication Space Parbai.Re <br /> j Quantity 1.,,3 Type: 13esidue + )ebiton LJ Full Taeledion <br /> Manliest Referende Number:• <br /> 17b Alternate Facility,(or Generator) U.S EPAIDNutnber <br /> • p 't <br /> LL Facglty's Phone: <br /> w ;17c:Slgnature.oi Alternate Facility.(or Generator) - t3 rt, Month - Day. Year <br /> 18.Designated Facility Owner or Operator:Certificralion of receipt of matedalseoyered;bythe,manifest except as noted in Ilerfi#.7a <br /> Printed/fy_ped Name =- `+ Signature, f s:: Month Day.'.1 <br /> Y <br /> f/ i <br /> TR414eit)RTEh 1.42 <br /> 169=BLC-O 6 10498(17iev.9/09) "• <br />