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Y <br /> J[ <br /> NON-HAZARDOUS 1 Generator's US EPA ID No Manifest <br /> 2 Page 1 <br /> WASTE MANIFEST K/A of j <br /> 3 Generator's Name and Mailing Address <br /> Slaby Sales Inc. <br /> P.O. Box 903; Borrego Spriage Ca 92004 <br /> 4 Generator's Phone( 760 )767-0776 <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transporter's Phone <br /> N/A <br /> 7 Transporter 2 Company Nome 8 US EPA ID Number B Transporter's Phone <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility's Phone <br /> WESTERN RNVIRON-MLNTAL Inc. <br /> 62-150 GENE WILMAS DRIVE <br /> MECCA CA 29 A 0 Qfl 3 6-0222 <br /> 13 14 <br /> 11 Waste Shipping Name and Description 12 Containers Total Unit <br /> No Type Quante Wt Vol <br /> a <br /> s a 'r rill-f"1 ' W4 0 n ft 5 0 P <br /> G b <br /> E <br /> N <br /> E <br /> R <br /> A c <br /> T <br /> O <br /> R <br /> d <br /> D Additional Descriptions for Materials Listed Above E Handling Codes for Wastes Listed Above <br /> 15 Special Handling Instructions and Additional Information <br /> dear appropriate clothing, steel teed boots. & gloves. <br /> Emergency 24 hour phone (8118)741--6600 <br /> Site@ (AGE) `? <br /> 1607 Turnpike. Rd. <br /> Stockton Ca 95209 <br /> 5 <br /> 16 GENERATORS CERTIFICATION I certify the materials described above on this manifest are not subject to federai regulations for reporting proper disposal of Hazardous Waste <br /> Pnnted/Typed Name Signature Month Day Year <br /> Zaida Harlow for AGE � ~; , ` <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials 1 <br /> A Printed/Typed Noer'-` c Signature Month t 'Day <br /> rp ` Yev <br /> P 18 Transporter 2 Acknowledgement of Receipt of Materials <br />' R Month Da Year <br /> T Printed/Typed Name Signature Y <br /> E <br /> R <br /> 19 Discrepancy Indication Space <br />' F <br /> A <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in item 19 <br />' T <br /> Y <br /> Printed/Typed Namee�rs 4_�C + ✓ f Si nature c l/4r = " Month Day Year <br /> , rr 9 �' <br /> 5 <br />' GENERATOR'S COPY <br />