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7' Please print or type r <br /> {Form designed for use on elite 112 pitch}typewriter I <br /> NON-HAZARDOUS 1 Generator's US EPA ID No Manifest 2 Page 1 <br /> WASTE MANIFEST N// Document of <br /> Generator's Name and Mailing Address <br /> Slaby Sales Inc. <br /> P-0- Box 903; Borrego Springs Ca 92044 <br /> 4 Generator's Phone( 760 ) 067-0776 <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transporter's PhonelO <br /> 7 . C` xY f• T 7 <br /> 7 Transporter 2 Company Name 8 uS EPA ID Number 8 Transporter's Phone '� <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility's Phone <br /> WESTERN k: IRONMEN'TAL Inc. <br /> 62-150 GENE WIUTAS DRIVE <br /> MECCA CA 92245 . P A R 0 0 0 1 5 7 201) 6 (760) .396--0222 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit <br /> No Type Quanta Wt Vol <br /> � a <br /> on—Razardoiks Waste Solid (sail. cuttinga) " "` 10 Dim 0 0 5 5 0 P <br /> G b <br /> E <br /> N <br /> I E <br /> R <br /> A c <br /> T <br /> U <br /> R <br /> d <br /> D Additional Descriptions for Materials Listed Above E Handling Codes for Wastes Listed Above <br /> 1 F <br /> 15 Special Handling Instructions and Additional Information <br /> Wear appropriate clothing, steel toed boats, & gloves, <br /> Emergency 24 hour phone (888)701--6500 <br /> Site@StefaULo's Gds° Station (AGE) <br /> 1419 E. Cha»Ver May <br /> Stocictian. Ca 95209 <br /> 16 GENERATORS CERTIFICATION I certify the materials described abase on this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste <br /> Printed/Typed Name Signature Month Day Year <br /> i - <br /> l T ? T Y �-_ tp ' <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials ^ '� <br /> i A Printed[Typed Name Signature Moa�f �Da ,}'ear <br /> Sys t y .1 1 t a {✓` x` ° t <br /> 4 <br /> P <br /> O 18 Transporter 2 Acknowledgement of Receipt of Materials ' <br /> TPrtnted/Typed Name Y Signature Month Day Year <br /> E <br /> R <br /> 19 Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> r 0 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> Y <br /> Printed/Typed Nam M nthr Day Year <br /> i Printed by J J KELLER&ASSOCtATES INC f <br /> Neenah w1 S4957 0368 GENER,4TOK's Copy 12-BLC;M6 <br />