COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

JSP.!1 : i• :.. ,:€I IF . , Please nnt;or ! _ p" ;;, f FormApproveu MB No. 2050-0039 P tYli� . is _. F1UNIFbRM HAZARDOUS 1 • Generator ID Number t . 2. Page 1 of 3. Emergency Response'Phone 4. Manifest Tracking Number WASTE MANIFE T' IF t CALI?JQ0144841 : 1 ' 201irV944-0912 " 1 J _1 IS CBF 5. Generators Name and Mailing Addres Generators Site Address (if different than mailing address) 3 : WLANO CO INC-: : 910 W. CHARTgR WAY si46 W CFNRTER WAY STOCKTON, Cid► 95206 STOCKTON, CA 98206 2Q9-944=0902 . .' + Generators Phone: 6. Transporter 1 Company Name U.S. EPA ID Number AMERIOPN VAl LEY-WASTE OfL, `tl 6 CAR0002723M 7. Transporter 2Company Name RLDWII� RECOVERY SYSTEMS INC 4 U.S. EPAIDNumber �R17 � I 19F, IF, - 7 11 IF v 4. . . V. . - _ .y ..t . .16.-r- . . . . _ i- } p.. f It IF 8. Designated Facility Name and Site AddrIF IessyU�A YES 2 WASTE .TRANSFERI FACILITY U.S. EPA ID NumberAZROfJt152114a 6500 US HIGImWAY 95' YLws . A2 85385 IF F -L 928-344-982f! Facility's Phone: 9a: 9b, U.S. DOT Description(including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11 . Total 12. Unit 13. Waste Codes HM , and Packing Group (if any)) t,V, : No. Type Quantity Wt.Nol. 1 • NON-MCRA I�il1ZARDOUS '`NASTt SOLID, ASSORRENYS & CAL DM .,�3f= 6r` P. o ' z . 2. IF - , FZ It PIF IF 3 t 1, Fig 1 Z�20 I FF U ad Fdde IF I IF It I IF OF IFIV, FIVE _ -- I _ _. _ W - . - - - - --.� , _ . _ _ p _ ._ IF 4. 14. Special Handling Instructions and Additional Information @ PROrIf.:E# 1. 9ta223NRs . .ABsCRgt►�r, a iL ER� 171 EI41FRCENCY C(SNTACT: ALLEN y • IF L v IF c� Lys IF 15. GENERATOR'SIOFFEROR'S CERTIFICATION: • I hereby declare that the contents:of;this consignment are fully and accurately described above.by the proper shipping name; and are classified, packaged, marI IF ked and lai:aWdlplacarded, and are to all respects in proper condition for transport according to applicable international and national governmental regulations. If export shipment arld I am the Primary IF ..Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknoWledgment of Consent. ' 46dify thatlhe.' Waste minimization statement identified in '40 CFR 262.27(a) (if I am a large IF generator) or (b).('dl am a small quantity generator) is true. Generators/9ffetors Pnnted[Typed Name - . Signature Month Day . Ye4 F"ar Fir FL I °ter . —� V IF Fit ,j 16. Intematl9nai Shipments Find ❑ Import to U.S. ' ❑ Export from U.S. Port,af entry/exit: Transporter signature(for exports only): Dale leaving U.S.: . w• 17:TransporterAcknowledgmentofReceiptof.Materials IF IF Transport ' I IF I LU VIVO inted/L Name Signature. , Month jDa Year ' 4 IF, IL ' .,.� �� IF T spo er d . yped Nam Vitt'. nth y e 18. Discrepancy.IF - 18a. Discrepancy Indication Space ❑ Quantity 11 Type El Residua ❑ Partial Rejection ❑ Full Rejection s Manifest.Reference Number: :" 18b: Alternate Facility. (or Generator) U.S. EPA ID Number J - !, V. •, . . it ra.tFi Facility's Phone: aW 18c. Signature of Alternate Facility (or Generator) Month Day Year . z 19. Hazardous Waste Report Management Method Codes (III codes forhazardous waste treatment, disposal, and recycling systems) 'U L 2. 3. 4. 20.- Designated Facility'Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printedrryped Nap Signature. Month Day Year CtN 01 mott�C A1 ) EPA Form 8700-22 (Rev. 12"17) Preyious editions are obsolete: }' f� DESIGNATED FACILITY rO GENERATOR