Laserfiche WebLink
I <br /> NON-HAZARDOf1S 1•Gerremtar ID Number 2.Papa I of 3.Emargelxy Response Phare 4.waste mracwg Nmnber I <br /> WASTE MANIFEST Sr a 1-., n <br /> &Generators Name and Mailing Address Germadoes Ste Address(f diiferem than maling eiddress) <br /> r`ZA)rt9ldllS)th7YE5tft1?titfl C.mp. <br /> 3!? S Cwitaf s:rE?1 131 t"rhamet Street <br /> ,toe iust,CA �Z205 135A �tvratort,C�:35C7�+ {p�. <br /> Genamla'ePhanettf�'=S}'soii5�f�!• . <br /> 6.Transwer 1 Company Mama U.S FFA ID Number <br /> ' 13QlIdt+3 l=rrtr;rnt;lllrer,tai stfefGr?r CA�"�^�•;3� 3 - <br /> 7•Transporter 2 Company Name U.S EPA ID Number f <br /> S.Designated FacEly Name end She Address F CU!fid; 1_hAll7t�Rt_ U.S.IPA iD Number <br /> Srl ::f[•".'i rt}ut} t 'fW' -�2 121,17 <br /> Fao1 k Phone::'rf.'• i?41 C-3-:1 i <br /> a.Waste&hipping Name and DesedpUon 10 11.Total 12.Unit ! <br /> No. Type Qtrardriy W1Nol. <br /> ¢ 1. t'i[5ie hiii? fHJIE..SPN�:;Y{SEfilti(Il<Crrl�a tiff ;trill [ 7 r;• `'r n .r 7i;::;�V; <br /> 3 <br /> 13 SpKW Handfatg Inslrudions and AddWonal Inlermadal <br /> c <br /> 14.GENERATOR'SIOFFERORS CERTIFICATION:I hereby dadere that the mntents of this mnalpnmenf are tuly and&mum y described above by the proper eVX*g name,and are d=44 padetgtd, <br /> marred and laboleWarardid,and are In all rMods 14 proper oamd m for trenswri amo*V to applkable international and nada W governmental mgtaaupns. <br /> GenerelOyP4Otferoro �rflW.TyypJ/ad^Name, manature Cff� ){ /rj�•yt�.t Month. Day Year. <br /> 1r '^r •fes /r� i - o <br /> t-" % /.i31 <br /> v�r j j } <br /> jig <br /> ts.Irsematiorral 3idpmeids ❑impod w U.S. ❑EWA horn US. Pat of en4lext <br /> T rter n ra for As (We le HS. <br /> 16.7rertsporlerAdmasled(utren101 Retdpt W Ma rials % _ <br /> Trensporler 1FTANene re r Ate'? MOMh Day Year <br /> SLA <br /> 7- Transporter PdntWyped Name SJprrature dAoe7r. ;Day Year <br /> r <br /> 17,D%croparicy i <br /> 170.Dlacrepancy N*mlon Space ❑GwAty ❑Type ❑Reefdue ❑Parilal Rejetdon ❑Full fiejecllon <br /> I <br /> Manttest Rofareme Nmnber. <br /> 17b.Alternate Fa lty(or Gumrata) U.S.EPA iD thmber <br /> J <br /> U <br /> LL F'aolllys Phone: < <br /> 170.Signature of Alternate Facflty.(ar Generals) <br /> Month Day Year <br /> i <br /> i��j �. y: -` 3 .,t•1z..�i�.te.' c�- Stir..:')'•:,�=w`siu':s5�;i: :*i::12;�' �'4'�x r _.:frS;•::'i�:i's'���:`5:..:.sr` _ �',��, S. - -i 1 <br /> O �. , - w �f �� ...r' rSY •� -r.-:+ t+ � c s n �. t tl-`• x c•k fi��" i t <br /> • _ 9 Y i CS } r ,r 1 s ?`• ��•` a :, i _ ''rip* <br /> i f •�Y'� -u!' q w`f !�Zt A J s2 ` Z �'4 y,i'f S> r z- <br /> 1.1& <br /> - <br /> a, _ "�y _ ..,, _ )ri. .:,�.. ::�a. _f :�.r�..}.., i.. Y y:i; �to:�. r•i �: z r r <br /> 18.Designated Faa'6tyOwnsor Operator.Cmikadon of recelpi of maledals covwW by ire rnartHest etxept as noled in Rem 17a Y <br /> Printed typed Name r� Stratum • s P"I Day You. It <br /> :f <br /> 169-13LC-0 5 11977(Rev 9109j TRANSPORTER#1' <br /> 'MAR 112013 <br />