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Pleeso print or typb, (Fort)) dosigmd for Use on el(lo (12"pitch) Iypevrrit(+r.) Form Approved, OMB Not 2050-bit3Er <br /> UNIFORM HA7ARDOUS 1 . Generator ID Number 2 , Page 1 of 3. Emoigency Rasponso Phone 4, f4anlfest TrackIng Number <br /> WABTP MAf11FE5T C A L 0 0 0 3 3 3 0 5 '2 1 ( sUOj ev) I "930U 018529066 JJ K <br /> 54unualu?eNrm arn! # r igxr�kess � 6witntrr3's , . ,?dilre5s fit riliortrttlwrnwalnpue'drossl <br /> I'VEV17If ?IXAfING rEf: 0Or,� <br /> PO BOX 5202 <br /> STOCKTON C?1 O (' RPf P'-f a; f; D <br /> Ct Wa;Vs P wl�j : 209 940-2623 S ( C) i ! (1'OIV CA 95216 <br /> S. Trans odv I Coo ,any h'rn rd U S. EPA ID Nurribw <br /> IK) RLI ) (' II Ir NVII7 NN {v1ENTAL SEs' RVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 74 Transporter 2 Ccrrpany Nrrnxo U :S> HA 10 Number <br /> VIORLDWIDE RECOVERY SY:)1-EhfI I (VC , GAR 0 0 01 7 5 4 2 2 <br /> 9 Des:gnatt'dFacnl * 115mpaudSi'.eAirdress U.S. EPA IDf4imber <br /> t t31v)1s tit CLGC"• <br /> 2730 E' 13TH ST <br /> YUMA <br /> F,acdry� sPftrole (f3,? } 3q °1 3G2f A 7., R O d q 1. 5 9 2 4 <br /> 9a, 91b. U.S. DOT Description (including Proper Shlpping Name , Hazard Class, ID Number, 10, Conloiners _ iL Total 12, UW1 13. Waste Cabs <br /> HM and PoetingGroop (if any)) No. Typo quantity Valwcd. <br /> 14NON - RCRA HAZAROUS WASTE, SOLID ( OILY SOLID , PAPER FILTERS) 352 <br /> D M P <br /> Fqx <br /> 3 <br /> MAN <br /> 14 , Special Han0l Instructions and Addilional Infunnalion <br /> EMERGENCY CONTACT : CHEMTREC F300 ti2 �a 9300 U'dOE5 T� RMIIrIAL: CORES C5 �' Pr OI= 11_ E dr 9C31 : 162C23NRSREt:Ot76 <br /> OILY SOLID . PAPER FILTERS * * APPROPRIATE PPE rQUiPMENT <br /> 15, GEttFIiATo}t^&IDFFERCR'S CERTIFICATIOtV: I I rcbpt detloru b.ot li}d canis=ni of If s cons`gnmpntera fully oed a ura4aiy dsscnbad clove by tlipproper Wppirig name, and pro dassif'al, pw:kagedI <br /> mar'nod and fntrnierttlt{ .aided, wid aro In ail res)i�tets In proper copearrn for trankl�ml aG.otd,rn to ppphAbto bilennillonuland national governmenlol iegu ailons. Ifexpod shipment and I am Me rehary <br /> Cxpartm, I cvn;1/ ihai 010 MINIM of IIS 5 con=_(gnn,00l conrolm to Ileo tk4mL$ Of lne aueehed ENAA0noo4iedpmenl of Cousr art; <br /> I corllfy 111514 file Wade ndn!mllafcxa Malauenl idant&W In 40 CFR 262 27(a) (d I am e Impe quantity pemeralot) or Io) (if I am a small quanlily generatot) Is Imo. <br /> Ceneratu siC1HepisP nlcoffycAName signslorsf Month D'ny Year <br /> i 6 , InumialionalShipmanis <br /> Export so _Sf— Import to U .5 Port of enilylexil <br /> Transpodor signature {fol espods only}: Dale loav ng U S <br /> 17. Transpodei Acfnowiedgmenl of pc alp' of t '.r • {m'"r�� � � n <br /> 20 Transpiler I Pnnlicrfyfrod hnmt' S jnnt r Mean Day year <br /> O71 <br /> z Tmns or a X12, t7typpd ll- arilo ydaa , , _ Moi h oily yeal <br /> F- <br /> 15 Gfst,epNn y — tJ <br /> alion Sp <br /> go ndiceco f�tt <br /> L� Ouanlily <br /> 18a , DisompaL ! Typo ❑ Ru. 1u+= ` ❑ partial Rejection ❑ Full Rejection <br /> _ Manifest Rofulenco Number: <br /> 18b. Albmate Fa0ly (or Goneralor) U.S, EPA ID Number <br /> 0 <br /> ILL Fro ,l(s phone: <br /> i9o, slgnalure ofkernate faclrify (or Generator) hlonlh Pay Year <br /> 19. Harardous Waste Report IrianagerneW f.elh of Codes (I u „ cones for hazardous waste Irealr))enh disposal; and recycling systems) <br /> 20 Designated �aNil Owner or O rarnlw : Ced�foalion of recei 1 of hazaruaus hralecals covered b the mmpd SI"encepl 0s a ed in lien lu„ � <br /> 4 f P <br /> 7 I,.p�Ilrx' <br /> F. PA Form 6 '021 (Arw,105) Pravloas rsbliuns aro at ss" CIPtrIV4`16) J` r-( [a) I"'MACIIJU TO DESTINATION STATE ( IF REOUIRED) <br />