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r - <br /> I�~ <br /> _AIZ�QUS 71 3i <br /> N(�N-HA 1 Generators U5 EPA ID No Manifest 2 Page 1 <br /> k WASTE MANIFEST 9ocrer P8° of 1 9/20/2004 y� <br /> N i <br /> 3S�a��t�sa1�5 and Mailing Address <br /> P.O BOX 9103 <br /> BORREGO SPRINGS, CA 92004 <br /> 4 Generators Phone( 888) 701 -6600 1 <br /> s 5 Transporter 1 Company Name 6 US EPA 1D Number A Transporter's Phone a <br /> FILTER RECYCLING SVS, INC --NO C A R 0 0 0 1 2 9 3 0 (510)670-9901 <br /> Try ns porter 2 Comp ny Name 8 US EPA I Number fi 7ransporter's Phone <br /> 7Fiter Recycling Services, Inc C A D 9 8 4 4 4 4 8 (909)873--4141 <br /> ti 9 Designated Facility Name and Site Address16 US EPA ID Number C Facility's Phone z;µ <br /> Filter Recycling Services, Inc. <br /> 180 W Monte Avenue (909)421-2012 <br /> Rialto, CA 92316 C A D 9 8 2 4 4 4 4 8 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> ' Total Unit <br /> a <br /> NON ITAZARDOUS WASTE SOLID No Type Quinti wt vol <br /> D P <br /> E <br /> v G b a S 45Tc 4Q rpt] <br /> N FILTER REC CLING SFR►11;�z^ r '�`� �r�r 1--AC 1LIT`l', E11A <br /> - pp <br /> Ac FPE <br /> R '� <br /> d <br /> s <br /> L <br /> Additional Descriptions for Materials Listed Above x* <br /> E Handling Codes for Wastes Listed Above <br /> { 11A)SOIL #04040923 <br /> 15 Special Handling Instructions and Additional Information <br /> Wear appropriate protective clothing OCAMPO PROPERTY ( <br /> AGE) <br /> ) <br /> 821 S. WILSON WAY <br /> 24 Hour Emergency Response # (909) 721-2038 STOCKTON, CA �d <br /> i <br /> BILI, SLABY SALES <br /> 16 GENERATORS CERTIFICATION I certify the materials described above on this manifest are not subject to federal regulafions for reporting proper disposal of Hazardous Waste <br /> Prtnted/Typed Name Signature Mo Do Year <br /> E <br /> T 17 ransporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> A Prnt Typed Name C_ Signature M Do ear <br /> 8 <br /> P <br /> O Transporter 2 Acknowledgement of Receipt of Materials { <br /> TPrinted/Typed dame Signature <br /> E Month Day Year <br /> x R <br /> 19 Discrepancy Indication Space <br /> IF i <br /> A <br /> C <br /> 7 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 k <br /> r <br /> Y — <br /> Printed/Ty Signature Mon/hp Day /Year <br /> (0 lJ' r/ e <br /> t3P(31NAL-P FTURN TO GENER4TOR 4. <br /> S rx 1 <br />