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FJr-- 777777M <br />GENERATOR'S COPY <br />NON -HAZARDOUS <br />1. Generator's US EPA ID No. Manifest ifest <br />Page 1 <br />WASTE MANIFEST ST <br />,2. <br />Fumqnt,�o. <br />of <br />75244 <br />3. Generator's Name and Mailin <br />,�,Addres., <br />U11-IjON 'ACRC RAi AD <br />C� <br />S,40E <br />S,TOC�-70N CA 0206 <br />4. Generators Phone <br />-S, —Transporter <br />I Company Name <br />6. US EPA ID Number <br />A. Transporter's Phone <br />r tAtf C- AU 0 7 '12 G 6 :.., :7 <br />7. Transporter 2 Company Name <br />8. US EPA ID Number <br />B. Transporter's Phone <br />. . . . . . . . . . . <br />9. Designated Facility Name and Site Address <br />10. US EPA ID Number <br />C. Facility's Phone <br />120MMERC;AL FILTER RECYCUNG <br />2035 E. 1,'Mi STIREST <br />LOS ANGELES CA 90021, <br />. . . . . . . .. <br />11. Waste Shipping Name and Description <br />... <br />12. Containers <br />13 <br />14. <br />ty <br />No. <br />Type <br />Total <br />Quantity <br />Unit <br />Wt/Vol <br />a. <br />N ON iA Z A P D C) U S WA 9 T E 'S' <br />0 U 0 <br />,)RAINED USED OIL PILTER <br />3 FOP, RECYCLING) <br />G <br />b. <br />E <br />N <br />E <br />C. <br />A <br />T <br />0 <br />d <br />D. Additional Descriptions for Materials List <br />W Above <br />E. Handling Codes for Wastes Listed Above <br />DRAINED USED OIL F)LTF-.PPS <br />FOR <br />RECYCLING <br />F. <br />15. Special Handling Instructions and Additi <br />)nal Information <br />0)X-PrM4CY PH: <br />VE.,&R APPROPRIAITILP, PRIM111"T."rVU <br />5) 3 <br />16. GENERATOR'S CERTIFICATION: I certio <br />the materials described above on this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste. <br />Printedrryped Name <br />Signat Month Day Year <br />T <br />-5-fpy oil I /M <br />f 0% <br />R <br />A <br />17. Transporter 1 Acknowledgement of Rec <br />Apt of Materials <br />N <br />S <br />P <br />Printed/Typed Name <br />Signature Month Day Year <br />O <br />R <br />18. Transporter 2 Acknowledgement of Reci <br />tipt of Materials <br />T <br />E <br />Printed/Typed Name <br />Signature Month Day Year <br />19. Discrepancy Indication Space <br />F <br />A <br />C: <br />I <br />I . <br />T <br />20. Facility . Owner or Operator: Certificatio <br />i of receipt or waste materials covered by this manifest as noted in Item 19. <br />Y <br />PrintedfTyped Name <br />_Signature <br />Month Day Year <br />GENERATOR'S COPY <br />