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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number <br /> WASTE MANIFEST CALFLt003944! 1 ? { =r 1s r; 013693985 FSE <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> Doilar Bcenc'r-ca! #14-6t Dollar Gt,ner ai#):4 1 <br /> 1940 MCHE NR Y AVENUE '1"1140 f it.:IM:N R f..3 t ili i: <br /> Generator's Phone: l=.Sf.;Fti-,O CA 95329601 0- E LALGN i CA `33320-960 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> 7.Transporter 2 Company Na P U.S.EPA ID Number <br /> 8.Designated Facility Name and Site Address U.S.EPA ID Number <br /> i 1s L�IiL�iT CI'#f - i Ll <br /> 20'1-t fi EW-Ianr s Dr, East <br /> 'er'nil y, INV 6-:1 16 <br /> Facility's Phone'r t+ ._ ,,.. iJ n, ;e A <br /> 9a, 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit <br /> HM and Packing Group(if any)) 13.Waste Codes <br /> No. Type Quantity Wt.Nol. <br /> 1. <br /> O ( f, s# a$ nay C tcmmCG4e lsQ-1C5q 7 , tt 5. rT IG< <br /> = + ani > 0,_ <br /> kAlcohoi; <br />