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Q0 <br /> N <br /> O <br /> r-- N <br /> 00 N <br /> 0) <br /> ti N <br /> N <br /> Ef') <br /> O <br /> d <br /> = i <br /> co <br /> O <br /> U O <br /> N s_ <br /> Form Approval WB Nc 2Mdi39` <br /> elaf 3Emergency Response Phone a-Mandee[ ;king Number <br /> 0 0 ISGO 424-930G 017 4 6 7 914 JJ <br /> T CHL '' l GenorW,'i,Silo Address(it dirterant man mading address) <br /> y�.a1J1NIF+ <br /> Heag rid MyRing Address <br /> AL cye F9'SLtR 1NE57EflN ft1 pT C!?S-ti.r'.&ilii <br /> V'C'Cox z15riX5335 1145'v'd Y48EVITC AVE <br /> GA <br /> 77£CA 209 823-1149 MAhITEGA CA 15337 <br /> Genarsror's Dene: n Name U.S.FPAIDNumber <br /> a rransaoner t Comlay CAD028277036 <br /> :h-OF? C)OfI-ENVIRONMENTAL SERVICES <br /> 7 TransyMer 2 Company Name U.S.EPAID Number <br /> a.Designated radlily Name and Site Address V.S.EPARD Number <br /> DEMENNO/KERDOON <br /> 000 N-ALAMEDA STREET <br /> COMPTON CA 90222 C A T O 80013352 <br /> Facil4 sPhcne_ (3 014;17-71nn <br /> ga 910.U S.DOT Descriplion(inducting Proper Shipping Name,Hazard Class.ID Number. 16.Containers 11.Total 12.Unit <br /> HM and Packing Gaup litany}} <br /> No. Type Quantity WINOI 13 Ware Codes <br /> I UN1993.WASTE FLAMMABLELIQUfD,N.0,5.,(GASOLINE.DIESEL. -- D001 0018 3 <br /> WATER).3.PU cm G <br /> o� �ALp <br /> ? 2. I— <br /> w <br /> ca <br /> 3. <br /> I PM11 <br /> � t <br /> 14.Special Handling InsWdmns and Adtlrtlonal Intormaton <br /> EMERGENCY CONTACT:Ci4EMTREC 1-800-424-9300 WOES TERMINAL:CERES CS NAERG#981:128*PROFILE#981 <br /> ,r <br /> N 396041 GASOLINE.DIESEL,WATER* "APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT <br /> .4-- TT!�v[J�r7,4 7 2�(36 <br /> f 3 <br /> 15. G£NERATOR'6lGFFEROR'S CERTITICATtON:I herebydedare that the contents Cl this consignment are fully and acevralelydescrihed ebovaty the preparshipping name,ard era dassihed,packaged. <br /> marked and labeleWplararded.and are in all respects In pmpar condbon for Irmmpad according to applicable intemagonal and nakona4 govemmental regulations,If exportsnlpmem and i am the Primary 1���NIL <br /> Espnrtar.1 certify that the mntants d this consignment wnferm to the terms of the ahached EPAAdmowledgmentof Consent J� <br /> I 1 Ne waste minimi icon statement identified m 40 CFR26217(a)(II I am a large quantity generator)cr(bI it i am a small quanlfty generaWQ is Uue, <br /> �•� a to1s10fte s Pd UKVTypad Na 5'tgnelrlFe Month Day Year -� <br /> w 16 Bonet Snrpments <br /> d Import to u /�/~ 0 6 Z� f aL 22l <br /> O ❑ExpoA nom VS. Pan of <br /> Transporter signature(for exports only): Date ievog U.S. r Of t <br /> ww 17.In spoft Acier"acgmanl of Receipt of Materials <br /> 3 l Month Day Year <br /> w Tran 1 PdntedR petl Na a Si,w— <br /> D <br /> a <br /> Transposer 2 PrloteatTylsed Tme S:gnalure MC111h Day Year <br /> 1B.Disuepanry <br /> 16a.Dist ePancy Indication Sya:z ❑ <br /> ❑Duani,ry' ElTip, Residue <br /> •!./�� ❑ ❑ParAal Rejection Full Rejection <br /> 1 Be.Ntemale Facility(or Generamr) Nastiest Reference Number: <br /> ti ,.� U.S_EPAIDNumhcr '3thr <br /> Q F-Ays P horre: do vit" <br /> fn1o"11111 U) <br /> N 41 <br /> 18,Sqacre of Allemate Fariir y(or GeneramrJ _ <br /> i Month Day Year LU <br /> 19.Hazardo'as Waste R M also <br /> 1 sport Management Method Cedes([e..mtles for hazardous waste Vealmen(disposal,and recyding systems) <br /> 0 3, +� <br /> O 4. <br /> ON 27 Designated Facdify Ownerar Operemr Carlifigtipnd ;g of hazardous materials cavaretl by Ise manllasl exce!as r1d 0 <br /> N O yewNams P ed in hem t C <br /> Signature O <br /> Month I)ay oaf fn <br /> r N EPA form B700.2.2(Rev.3-05(prev ous editions areco <br /> r N G••i obsolete_ , I � <br />