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y <br /> Pleasepr9rtortype.(Fofmdesinedformwelrte(12-pitch)t"riter.) Form Apprwed.OMB No,2050-0039 <br /> } UNIFORM HAZARDOUS ' <br /> 6enamlw ID Nunda 2.Page 1 ef 3.Emergency Respomem Phome 4 01 1 412 0 JJ K <br /> WASTE MANIFEST CALLocIscDD3S r^, 5110 <br /> 5 Generators Nameandklaliry AdarmsGaemtols Sae AddressladRerent Nanmakngaddmwl <br /> GGyy <br /> 461 N SAN JOSE sftca T <br /> 3TOCK7OI•!,CA 962]3 <br /> GenerdblsP -. - � <br /> 8.Transporter 1 Comparry Name Y U.S.EPA 10 Number <br /> Rv6105 ENVAONMEl 5ER:ICES INC: ....).sL <br /> 7.Transporter 2 Company Nemo US EPA O N,mder <br /> 8.Oesgiated Faclly Name and Sea Adeam" US EPA ID Number <br /> R=MOS EN',^1RON9AENR,L SER-CES,INC <br /> 1515 St7-RIt Rh!ER RD C+O111wir -95 <br /> WEST SACPAMENTry C- "at <br /> F Nwna`g F l "r <br /> Sa. 9b US.DOT Desorption Inoubug Fops Stgpig Nate^Haunt Clava,10 Numbx, 10.Cpntaimrs it Total 12.Una <br /> HM ad Pedgng GmOm <br /> my No. Type Omy W4AkI. 1a Week Codes <br /> 1 '1•'<A0tu1S V,'-:TF, <br /> Z 2. <br /> W <br /> pp <br /> 3. <br /> d <br /> All <br /> la Flatdlptg NSbucaone and Additional Intermission <br /> L HEALTH <br /> 961,Pla(*'i ERGM71 DEPARTMENT <br /> EP CONTRACTOR RAMOS aNvIRO MENTAL <br /> c1ANDLERS SHOULD BE TRAIt4i ,.ND USE AppRO"ED PPE <br /> 15, GENERATOR'SIOFFEROR'S CEROFiCATION: I hereby cedar,lout the contW of this caugnment are My and Kmva*described some by the proper sNppeg name,and ore car"W,packagi <br /> ,ranked and IabeledPlacarded.and—in as respeois in paper conshoCtI ror transport swadng to appIcable inlemal,"end national govemmental regdaapns 0 export shipment and I am tM Primary <br /> Erporkr.I w"that Ne caVotits of this arraignment conform to the lerms of one aladud EPA Acknodedgrrenl of Contend, <br /> I cagy that the rs9e ra miaadon slalmed iderdfled slog CFR 26227(a)ft l am a WW Wally gerierabN or lb Of l ai saw e8ue. <br /> Genera di'VOlWd's PdSign w l Monty DDeeyy Yom <br /> 41 _A L L,L -L t-_. . Lt/G 1 <br /> J 18.International Shipments, <br /> F ❑Nrppdb U.S. ❑E>p<(alhpm U.S. Pon darlay/adh <br /> = Trareporw sguhn llorellplaa arty): Mlelseylog U.S.: <br /> q IT TrnspaMrMroAladytaa of Rebels of Masi <br /> iCe Tramoorm,1 Praamryped M <br /> I II Dar rear <br /> QransporlePnnted'f <br /> Ter,2 yped Name <br /> Month Day Year <br /> z <br /> i18 unrsaancy <br /> 182 Disaepacy Ind,umOn Si usbaby ❑Tnn ❑Revdue El Partial Rated. ❑FW Rejaosn <br /> Mandan Reference Number. <br /> 18,Ntemak faddy for Generator) U.S.EPA ID Nwbw <br /> J <br /> V <br /> LL FwNtys Phone. <br /> 18c&gmbjmo ANMmak Facky(ot Gereastan Monty Day Year <br /> 19 Hua dour Waste Report Ma sgenem Method Codas II e.,codes ter haaanbus easle testament,depose,end reyoing sysMmsl - <br /> 2. 3 <br /> I I I 1 14 1 <br /> illll 20.Oasgnamd fir Oeraror Oparaloc CeM1®mn o/raelPl of nazallous malarias wvered try Use maNlest enact as noted in Ikon 18a <br /> Fm fled Nianne ) aNre /Month 0ey ear <br /> EPA Form 8700-22(Rev.3.OS) setlioore are obsolete, DESIGNATED FACILITY TO GENERATOR <br />