Laserfiche WebLink
Please pcirrl or type,(Fafm designad for use on stile(42-pkfi)t}Tfawnter.) Farm Apprc, :.1 EAB No.2050.0039 <br /> UNIFORM HAZARDOUS t.Generblar ID Number 2.Page 1 of 3.EmergencyResponse Phone 4.Manifest Tracking Number <br /> WASTE MANIFEST C.A D 9 8 1 9 6 7 6 8 0 1 (800)424-S .017468148 JJ K <br /> 5.GenerAy9 Td �;�1i7 AS'dII, <br /> rq Generators SlleAddress(If diffarenl Ihan maling address) <br /> 333,3 RUTO CENTER CIRCLE <br /> STOIDPON C CA 95212 <br /> Generators Phone' 209 477 3668 <br /> ti.Trangppnef 1 em anyy l�ama U.S.EPA ID Number <br /> 'MOR ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7 Trimpodw 2 Company Name U.S,EPA ID Iwrrbor <br /> &.Desigulgd�OOly���11�B N�eING U,S.EPA ID Number <br /> 6375 SOUTH BOYLE AVENUE, <br /> LOS ANGELES CA 90058 C A D 0 9 7 0 3 0 9 9 3 <br /> Facility's Phone: _(323)277-1500 - <br /> 98. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit <br /> 13.Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity WINol. <br /> 1. NON-RCRA HAZARDOUS WASTE,SOLID(OILYSOLID.,PAPER FILTERS), 352 <br /> ad • Z D-M ! P 1 <br /> W .......... -- <br /> u� <br /> 3. <br /> 4. <br /> 14.Special Handling lnstnrdions arid Additlonal Information u <br /> EMERGENCY CONTACT:CHEMTREC 1-800-424-9300 *PROFILE#9B1:P211550 OILY SOLID,PAPER FILTERS <br /> P500-000.35489*APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT Z� <br /> 15. GENERATOR'S;DFFEROR'S CERTIFICATION:1 hereby dadara the!ilia contents of this consignment are fully and accurately desc*ad above by the proper shipping name,and are classified,packaged, <br /> maiked and labeled/placarded,and are in all respects In proper condition for VranTort aocording to applicable intomatlmwt and national govommental ragulallrms If axportshipment and I am the Primary <br /> Exporter,I certify that the contents of Ibis consignment conform to the terms of the attached EPA Acknowledgmunt of Consort. <br /> I certify that the waste minlmizallon statement Identified in 40 CFR 262.27(a)(If I am a'IaTge'quanlity gennralor)or(b)fill am a small qu n01y gameralar)is true. <br /> Gan raloeW0lferasPruntadawadNar sgnal rtanlh OW Year <br /> a z 1 <br /> =-1 15.Intemational Shipments <br /> F— [Iimport to U.S. Export from U.S. Pall of entrylex L <br /> z' Trarrsportef signature(for experba only); Dale leaviq U.S.: <br /> WL -17.Transporter Acknowledgment of Receipt of blaledals <br /> Tra a~porler 1 PnntedlTypad Name 5 ra hlanlh Day Year <br /> a Y � �� <br /> Z Transporter 2 Pnnled/Typed N:ms Slgnalum Month Day Yuar <br /> Q <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space ❑ Quantity E]Type ❑Residue ❑Partial RejectionI <br /> ElFull Rejection <br /> y Ma geM Rolorenm Numbr•,r. <br /> F— 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> U <br /> Fadllty'S Phone: <br /> w 18c Signature of Allamate Facitdy(or Generator) Month Day Year <br /> Q <br /> z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling syslems) <br /> Q <br /> 20,Designated Facility Owner or Operator:Certification of receipt of-hazardous materials covered by the manifest excapt as noted in Item 18a <br /> PrwtadlTypod WSma Signalure Month Day Year <br /> 1 <br /> EPA Form 14700-22(Rev.3-0a) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />