Laserfiche WebLink
a <br />� ore�ee nrini nr K7 ie rFnren rincinnai fnr „m nn dila r/9.nifrt,l ivnm.niim 1 <br />�n�ns��nu <br />Fan Anntavad_ OMB No" 2050.0039 <br />' <br />UMFORM HAZARDOUS <br />1. Generator tD Number <br />2. P* 1 of <br />3 <br />3. "VV41 Phone <br />4. Manifest Tracking Number <br />0047®11.2fi FLE <br />,WASjjMANIFEST <br />C A,.(. 0 0 0 3 5 7 4 13 7 <br />(800) 924-M04 <br />5. erafor's Nam and Mailing Address CVS #3gpg Gmreratoi a (d,eerettt than main address) <br />1685 West 11th ✓tmat <br />Tracy, CA 96370 <br />Coenerskos Phone: <br />rensporterparry Name U.S.iN S Number 0 0 t 1 0.0 2 4 <br />SterlcO, a Specialty Wade Solutils Inc <br />7. Transporter 2 Canpany Name 0 Number <br />All Chemic tf L7ispog'al lrtt: Ic A EPA f® 9 8 2 4 9 2 3 9 9 <br />a Designated Facility Name and Site Environmental ErtterrAse 3, Inc. U.S. EPA ID Number <br />46513 Spring Grove Ave <br />� (51?,) 541-1923 Cfndnnatt. OH 4522 O H D 0 9 3 3 7 7 0 1.0 <br />Fara6s Phone: <br />ger• <br />9b. U.S. DbT Description (k>ckrdfng Proper Shipping Name, Hazard Gass, ID Number, <br />10. Containers <br />11. Total <br />12. Unit <br />13. waste Codes <br />No. <br />Type <br />HM <br />and Packing Group (d any)) <br />Quantity <br />WtJVoL <br />a <br />t, <br />150, UN3077, Waw EnvPrOnfT ntally haaardetuia subsance%-solid, <br />p11 <br />541 <br />X <br />n.a.s. (Siiverj 9. PQ fll, (D91 i ),ERC -f 71 <br />001 <br />CF <br />30000 <br />f <br />w <br />2#. N 1950, i taste Aerosols, @arnrrtable. (each not exceeding i L <br />0431 <br />214 <br />cs <br />X <br />cspa*)j ((3ularre. Praana) 2.t, . ERC -7-126 <br />001 <br />CF <br />30004 <br />P. <br />3UP4VJ93, Waste F•larM,&e ligWdfs, n o -s. Psoprop,11 Alcohol, Edtanol) <br />D001 <br />214 <br />X <br />3, PG ll, ERG -921 <br />gal <br />CF <br />30002 <br />P <br />4t31+11780.4`hlsts Gtmasive 4ic11*da,11.R 9. 4Sc>�#tislr5 HydMXide,W02 <br />922 <br />X <br />AJtivriohiurn Hydroxide) A, P(3 2l, ERG -164 <br />009 <br />CF <br />3af)01 <br />P <br />fo <br />11. t�ttf43i-Gi�F l 48874, <br />2. X7i-s3'2-CV(Consunrier Products, Aerosol) 4291319 <br />3. X75349-CV(Consurner Products, Flanrsnl?ble) <br />4, X75349 -C 1(Wuio Conswyw Predum, 43s c) <br />15. GENERATOR'SIOFFEROR'S CERTIICATIGN: I hereby declare that the contents of this constremmrt are fully and awirately described above by the proper shipping name, and are classified, packaged, <br />marked and labefedtplacarded, and are in all respects in proper condition for transport according to applicable intomallwal and national govermnental regulations. If export shipment and i am the Primary <br />Exporter, i certify that the =ft -ds of this consigrumt conform to the terms of ttte attached EMAdowMedgment of Consent. <br />I certily that the Www m inidzafw statement Iderdified In 40 CFR 282.27(a) (d I am a large quantity generator) or (b) ('d I am a small quamity, generator) is We. <br />era sn ame Month Day Year <br />I-Yaj A lA A 7 127 Ill. <br />J <br />`krternatiarel Stripniients ❑ i ❑ Export from U.S. Pat of enbYlexit <br />Transwer s nattxe fa exports onm: Date lea U.S.: <br />17. Trenspater o1 Recur of Materials <br />y ear - <br />Transporter f <br />Re <br />MarvA Howard cr.. ___ r 1 <br />Transporter 2 yped Near <br />L�--Kff t <br />18. pisaepancy <br />EIV18a. Discrepancy indication Space ❑ t City ❑ Type ❑ Partial Rejection ❑ Ful Rejection <br />Manifest Reference Number. <br />18b.Alternate Facility (orGercevata) U.S. EPA ID Number <br />3 <br />� <br />F s Phare: <br />18c Signaaue atAltm ate Facilty;a Genera0or) Madh Day Year <br />�1 <br />• <br />N19. <br />Hazardous Waste Report Iftnagemo M +od Codes (i.e, cows for hamlous waste VMMV rt disposal and necyd% systems) <br />®1 <br />2 3 <br />4. <br />20. Designated Facility cadcaticn d meeipt or ha&&Z rarow except as •• ! �` / <br />PrinleciffypedName Sipnare �../-- Day Year <br />r 1 . i y t ►7 r> ' ' �" ' <br />