Laserfiche WebLink
NONHAZARDOUS Document Generalor s US EP4 ID No Manifest 2 Page 1 ;t <br /> WASTE MAN�EEST bacumen, Na of 1 <br />//3,T7;ratoe"'Name and Moiling Address <br /> Service Station <br /> 749 East Charter Way <br /> 4 &%2,c o�pajneA 537-0171, <br /> 1 6 A Transporter's 6Phone <br /> ��- <br /> 7 Transporter 2 Company Name 8 US F:PA be 7 8 Transporter's Phone <br /> U(104 L `JJ�r44YYL.rJ L J 3r 8 t.� a �" <br /> 9 Designated FiAility Nome and Site Address 10 US EPA ID Number C Facility's Phbne <br /> D/K Environmental <br /> 3650 E. 26th Street <br /> Los Angeles , CA 90023 C A T 0 8 0 0 3 3 6 8 213-268-5056 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit ' <br /> No Type Quant t Wt Val <br /> a Hon-Hazardous Waste , Solid, (NONE ) 0 <br /> b <br /> 1 <br /> 1 c <br /> d <br /> D Additional Descriptions for Materials listed Above E Handling Codes for Wastes listed Above <br /> a. SOLI <br /> 15 Special Handling Instructions and Additional Information <br /> If undeliverable, return to Generator. Wear <br /> appropriate personal protective equipment . Emergency telephone : (209) 537--0771 <br /> 1 GENERATOR'S CERTIFICATION I certify the materials described above on this m est ore -bled to federal regulaho r reporting proper disposal of Hozorcioos Waite <br /> P me /Typed amt ature Month ay ar <br /> 17 sparter Ac led erne of RecWpi of Mat <br /> t1wkAte- <br /> Si ° <br /> W�k Nc----� =�e <br /> t 18 Transporter 2 Acknowledgement of Receipt fif Materials <br /> Pn a Typed risme O /} _ Signature Month Day year <br /> [ tj <br /> qj <br /> 19 Discrepancy Indication Space{•`\1\l�f1Jf.7_ 9V1 `r']I <br /> i <br /> 20 Facility Owner or Operator Certification of rece:pl of waste materials covered by this manifest except as noted in Item 19 <br /> Printed/Typed Nome Signature Month Dar year <br /> SOC ATES NC N - Now <br /> s <br /> �wi tti7r -ir7 ri sr� < I L r-,�-' Ir^N TC) (- 1. ZS' > <br /> - _ G <br />