Laserfiche WebLink
"T Please on or type.(Form designed for use on elite(12-pitch)typewnter.) Farm Appmwed.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page l of 3.Emergency Response Phone 4,Man list TrackingNu [; <br /> WASTE MANIFEST CHL000590320 209-922-32'71 0 37 3mbrt 8 2 5 G B F <br /> 5,(w earakls Name and Malgng Address Comeratols She Address if shipment than coshing,All it <br /> JM EOUIPINENI CQ-MANTECA <br /> 321 SFRECKELSAVE <br /> MANl 95356 <br /> Genemlols Pho <br /> 6.Thimpoder t Company New U.S.EPA 10 Number <br /> AMERICAN VALLEY WASI"E OIL, INC. CARD00272302 <br /> 7.Transposer 2 Company Nem. LLS.EPA IO Number <br /> WORLDWIDE RECOVERY SYSTEMS INC CAR000176422 <br /> 8.Designated Facllhy Name and Site Address; U3.EPAIOI'l <br /> YUMA YES LLC AZR000175422 <br /> 2730 E. 13TH ST <br /> PUMA,AZ 85365 <br /> Fri Pnone' <br /> 8e 96.U.S.OOT Description(indudin,Proper Shipping Now Haurd Class,ID Numbep 10.Ccntln.rs 11Tolal f2.Unit <br /> HM <br /> and Paling Gmup(ifanYD - No. Type Company, yelll. 13.Waa@CDdes <br /> p NON-RCRA HAZARDOUS WAgTF SOill l ARSORPENTg R OII_ 2 DM 290 P '� <br /> z <br /> ob <br /> u <br /> 3. <br /> 4. <br /> 14,Special Handling instructions and minimal m®ra tlon <br /> PROFILE# IOM74NRS ABSORBENTS,OIL ERCW71 <br /> EMERGENCY CONTACT'. ROY <br /> 15. GENERATOWMFFEROR'S CERTIFICATION: I hereby declareXtatthe prowneof Ne mnegnm fully and accumtydescnbad abore by the pmpersbipping name,and are classiral ,ackpged, <br /> mmamaMIab.kdifir Ned,andare mall reepece inproper scratch for Iresswrtedording to applicable Imornaloneland national governmental regulations.lferpwtshipmentand Iamthe Fdmary <br /> Espone5l cetlify Ihet as contents of this consignment conbrm to tho arms of the atlachad EPAACNnmWetlgment of Consent. <br /> I carry than the waste minlmhatipn statement identified in 49 CFR 26227(4)td I am a large puentlry Aeneralm)or(b)let am a small Wantgy genet <br /> CanaratomsQlarots Printatl?yped Ne 8ignakre Monty Day Year <br /> Zo c� li✓�KelRhdr7 1 <br /> 16.Intanat'Iwtel Shipments <br /> {_ <br /> El[.,ad to U.S. Expos Portof enkylexlt <br /> Transporter signal par axppds ori Data devin9 US. <br /> ¢ <br /> 17.TrmsposerWnowiedgmm[d Re iWp Matedzls <br /> K Trens it Fire drt S' on Day YiDlp -71 <br /> r <br /> O <br /> 6 <br /> op <br /> T, _ paid N e nth ay Y <br /> F J <br /> 18.Ordespel e <br /> 18a.Ois an,y lntlimlbn Spam ❑ Ouedtiry ❑Type ❑Residue [A Panel Refection El For Ross n <br /> Manifest Reference Numbar: <br /> 186.Attempt Fedlity(or Generator) U.S.EPA ID Number <br /> U <br /> LL <br /> Fri Phone'. <br /> w 18c.Ggnature ofAltemite Family(a,Cantata) Month Day Year <br /> a <br /> z <br /> N19.Heaardoua Weak ftepotl Man agement Method Codes(i abides for hazardous waste andonment disposal,and recycling systems) <br /> W 1. 2. <br /> � 2o. ' naled Fatiliry Ormera0perator.Control of remlpt of hazardous matenals dowered by the manifest extant as Road in Item too <br /> FU <br /> Na gnaNre Ih D; Y <br /> ea <br /> ITPA For 8]0 22(famir.3- 5) ravtoua etlitione are pbao ate. <br />