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FORWARD APn O LK_'JCr^7 SPC-4323 <br /> 2s.... ........ <br /> e <br /> NON-HAZARDOUS 1. Generator's US EPA ID No. Docume�tsNo. 2 Page 1 <br /> WASTE MANIFEST . . . . . . . • 1.4 p� 1 °f 1 <br /> 3. Generator's Name and Mailing Address <br /> l'estqpa Trust <br /> 1431 Atteba ry Lane <br /> 4. Generator's Phone( ) <br /> Sari Jose, CA 951 31 800-746-74,19 <br /> 5. Trow p�orter l Ccp y Name t� 6. US EPA ID Number <br /> l vri"Cl i. Le_I_a1 J�iEJi CO <br /> 7_ Transporter 2 Company Name B. US EPA ID Number <br /> 9: Designated Facility Name and Site Address 10. US EPA ID Number A. Transporter's Phone <br /> ForsNar c� inc. B. Transporter's Phone <br /> F.C. F .; 46 3?J {'� C. Facility's Phone �( <br /> S t.�.C;;.t C�3 �'3 i 5 2 LI 7 A :-{ <br /> 11. Waste Shipping Name and Description 12. Containers Total Unnit <br /> No. Type Ouanti Wi/Vo! <br /> a. <br /> Loa .. -eit-11 _ =Lrol.-_u aIi—droCa?'"bons <br /> G b. <br /> E <br /> N <br /> E <br /> R <br /> A c. <br /> T <br /> O <br /> R <br /> d. <br /> D. Additional Descriptions for Materials Listed Above E. Handling Codes for Wastes listed Above <br /> r^. <br /> o� �w <br /> 15. Special Handling Instructions and Additional Information <br /> 16.GENERATOR'S CERTIFICATION: I certify the mo+enuk described above on this mgnlfest ore not subject to federal reguiations for reporting proper disposal of Hazardous waste. <br /> Printed/Typed Name Month Doy Year <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials / <br /> R <br /> A P ' ted/Typed Name Signatur Mgh �ay Year <br /> F, <br /> 0 1 B.Tronsporler 2 Acknowledgement of Receipt of Materials <br /> R <br /> T Printed/Typed flame Signature Mor,th Day year <br /> E <br /> R <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> L 20-Facility Owner or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19. <br /> 1 <br /> T <br /> Y <br /> P{anted;Typed Nomq ` Signature <br /> Month ,Dt j'eo <br /> tk <br /> I i 2 <br /> r ,A <br /> TRANSPORTER #1 <br />