Laserfiche WebLink
Please print or ryp.)Fam de ned for use on elite(12-pIch)ty�ewriler.) a FomlApproved,OA19 No.2050439 <br /> UNIFORMHAZARDOUS i G,'—,wor rD Numb. 2.Pape,of �.Ernarperwy� nse Ph.. a.XlanHeH racldrsg W <br /> WASTE MANIFEST CAL0003180T58 08.334- 003529518 G B F <br /> 5.Gwn mors Name and MeibN Addrcae Ganera'de Site Addrau(11 d'MM Than meaeq addM.) <br /> ACME SAW&SUPPLY-LODI <br /> Y 1♦N.b^ t(AMW Mtl by <br /> LODI,CA 85240 <br /> Gen he.,ProrJW-334-3386 I _. <br /> 6.Transporter 1 Comparry Name U.S.EPA In Nrunlrer <br /> AMERICAN VALLEY WASTE OIL,INC. I CAR000272302 <br /> 7.Traap"2 Company N."� U.S.EPA ID Nl mbar <br /> STERICYCLE SPECIALTY WASTE SOLUTIONS,INC. MNS000110924 <br /> 8.Desy.W Faaey Nam and She Addle. U.S.EPA ID Number <br /> CHEMICAL RECLAMATION SVCS TXDD4F3844700 <br /> 405 POWELL STREET <br /> AVALON,TX 78823 <br /> FuiW'Prme872.827-3224 <br /> 9a, 9eU.S.DOT Doscnol$x(oduoing Hooey St: lq Nemo.Hazard pas,,ID Nmber. 10.Cont1t11.Total 12.UHt 13.Waste Coons <br /> HM .d"661 Gro.q Pt-Y)) No. Type O"tity YAW <br /> X I RQ,UN1993 WASTE FLAMMABLE.LICIUIDS,N.O.S..3,PGII, 1 DM 55 G DOM DO 18 331 <br /> O GASOLINE,OIL <br /> � A - -- IXJT6 211H <br /> Wia 2. <br /> CW7 _..._ <br /> 11.SDaoai 1-111*111011.Wl and AdOrten.al hetaina'Jon . <br /> PROF ILE01915308-00 GAS 8 OIL ERG#128 <br /> EMERGENCY CONTACT:JOHN <br /> 15, GEN ERATDR'WFFERORS CERTIFICATION:I hereby declare that Ne an,ems of this mnaigrwohr are My and a mmy described above by Oro pmm chippirg name,and we dasose,packaged. <br /> mwI.M and Iebefe&pu d d,and am In as respects N VW casSLVrr br a an W accereinp to applicable inlenaeonal ON rreC4nal goemnenral regulations.II expel ahipmonl eW I am the PMsary, <br /> Eayngr,I�Y he(the conbnte d dr4­0­1—dorm.the Tema or t e aaachad EPAA kro./adV.PI of CD—L <br /> I mtly that the wade mWlniiat on s!atamenl Nerlllbad In la CFR A2.27(a)(i I an,a lame gwnury generator)or(b)(If l.n a smab quanRy generator)is tragi. <br /> Garmtcew ora%Prwed(Tyap",," r4n Monty a Y an <br /> .Inlematior�al iprtams rr-' "__...� <br /> Import to U.9. L�J E,pon;m S. Port of enbyledP, <br /> Dg.".egnatwe!tor e,pons oNyl. _ Dala bavuq U.S.: <br /> IT Traspasa Adrrna,edpneM of Romp d hlelc631s <br /> ra I Pnm Nam 51 Monty pay Y ar <br /> ars J 1 /lV" <br /> Zd Tye 2PnnIeM Name SipnoNra XIor1N Duy Year <br /> tan P,aepancy <br /> I8a.Diauepanoy.In&aWSPaca DQuanliry �_�Type UResides L�Pwtal Reardon ❑Fua Rgecom <br /> _ ManAosl Ratarance Number. <br /> I8b.Ah.nate Faddy(or Gemmw) U.S.EPA O Number <br /> U ( <br /> tai Fao,dy4 Prone' <br /> W ik,. aWre of M.—ie FacUhy(or Gerr.akv) --�-- — N Day Year <br /> 19.H endow Wase Repan hlanagn A Method Codes(i.e.,codes for waroms waste veelmenl,die mI,ane recydvV systems) �— <br /> W 2. 7. �. <br /> 0 <br /> 20.N.I;nalad Fadety Nris,a opc tor:CeltincaJen of MCagl d I1 allouS nelerfal;coved by Ne 'fe�tlea,ce as Med n Nem 18a <br /> Month Day Y", <br /> los VowEPA Fonit 87W22IRev.3-05)Prevqus elutions are obsolete. C <br /> DESIGNATED FACILITY TO DESTINATION STATE(11 REQUIRED) <br />