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<br /> VNIFORM H��kZARDC�O�US
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<br /> larrf-and Mlalliig Mflwsi, �Geiaralcr's Site Adcres than mild"u)d(fdreW
<br /> M,,V,ter i_n Valley is reser Co -Offerer" 1019 Bessemer Dx -
<br /> PO 15006 2569 Mante-ca, CA 95.336
<br /> M&nteua, CA- 95336
<br /> U S I'PA 11)Nwrihei
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<br /> HC1 ENVIROMENTAL EINGRYEERING SER VICE CAR000176026
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<br /> 041-1 V.COMPAII Nerve
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<br /> I Name and'Site Addnr.Fa
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<br /> CORP.
<br /> 425 ISIS AVENUE
<br /> INGLEWWD, CA 90301
<br /> CAD008364432
<br /> 323�-776-6233
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<br /> .7, GENERATOR'SIOFFEROR'S CERTIFICATION:I herabydorlare.lhaML contents of this consignment are fully end auorale'y descrtiedaniove by t"L jin"Pe'sh,pping name,at are class fieri,p;1*711.,:
<br /> riarkx<and labe fidlplacarded,and are in all respects in p,oper co,ncslon for transport acrording to aDplicatite inofmol,cinaiarc i;i!mal grovPmmenta requWbns 11 eynort shipment and I am the Primary
<br /> laxporIv,I ceil,f%thatilho contents of this consignment conform to to terms of the attached PAAJrow*dqnien1 of Cfinsow
<br /> I cemfy that the"wasle minimization statement identified in 40 CFR 262 271,a)til I am a large awrifty qenprator),,(W(J tarn a small quar1firy)pnenflo,)is tup,
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<br /> Transporter signature(for exports only) D,'v,Imavinn LJ S
<br /> t� 17 Transporter AcknoWedgmeW of Roroi;Gl of Malerials Year
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<br /> 18 iscrepar cy
<br /> 18a Discrepancy Incication Spacc, QantiIQuantityj Re!'Idtx poll Rejection
<br /> MrAdeSI tillf.O(OiCe NOWN"_
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<br /> I'- "AT--flF PLOUFFIF It
<br /> P-41�-rrnl 8700- 051 Previoil. ar otrsolcitn ;,-1ATED FACILITY TO DESTINATION SIAT
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