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018237799JJK <br /> Please prrnl or type,(romt lest ned for use on elite(I2*tch)IypewriWr.) Form Approved.DMB No.2050-0039 <br /> UNIFORM HAZARDOUS t Generator ID Number 2.Page t of 9 Emergency Response f7rorar 4 Manifest Trac Vng Narnbor <br /> WASTE MANIFEST CAL 0 0 0 3 7 1 7 16 1 (80O)424-9300 D 18 2 3 7 7 9 9 J J K <br /> 5 Generalnr's Hama and Mfh lirrg Aorlr*;p Ger+eralols Sitekdraas(ddillwenl than trialling awfess) <br /> PAUL BLANCOS GOOD CAR COMPANY <br /> 3190 AUTO CENTER CIRCLE <br /> STOCKTON CA 95212 <br /> &I'llArawrs Phvna: 916 928-4460 <br /> 6 Trandp 6)r 1 Company Name <br /> U-S-EPA ID N umbar <br /> ASBURY ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7.Traftpor4 r 2 Company Name <br /> ij S.F,PA ID Number <br /> 8 Des grated rcnli;y Name and Site Mede s U.S.EPA ID Number <br /> US ECOLOGY VERNON INC <br /> 5375 SOUTH BOYLE AVENUE <br /> LOS ANGELES CA 90U58 CAR 0 9 7 0 3 0 9 9 3 <br /> Facillry's Hone. <br /> 9a. 91b U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Cordainers <br /> 11,Total 12.Unit <br /> HM and Packing Group(d arry}) 13.Waste Codes <br /> No- Type Quantity Wt.Nol. <br /> c 1' NON-RCRA HAZARDOUS WASTE,SOLID(BRAKE LATHE SHAVINGS) t 5b 181 <br /> L } <br /> ©M <br /> w <br /> x z. <br /> UJI I { <br /> 3 <br /> f <br /> 4. <br /> 14.Special Handling Instructions and Additional Information <br /> EMERGENCY CONTACT:CHEMTREC 1-800-424.9300 WOES TERMINAL:CERES CS NAERGW 961:171*PROFILE 981:7 <br /> AP192387 BRAKE SHAVINGS*P500.00049287 *APPROPRIATE PERSONAL.PROTECTIVE EQUIPMENT/ r.7 <br /> 15. GENERAMR'SIOFFEROR'S CERTIFiCATIOWI.I hereby dedam that the contents of the consignment arojully and accwat*eartrbed above by Vic propor shipping name.and are dass&d,packaged. <br /> mw4ed mid W6 wpiacarded,and are ke eW respects In VrWar condMon for lrmnsport acacrsng to appkawo Brtwnadonata m national ge rnmenlal regulaaloaa.if aapol sfeprncnt aNnd I am the Primary <br /> Ex}x W,I panafy thilt the C001"W tNs carrelgnrnenl confanm to tho tortrrs Cd#R attechod EPA AOTOWIedganenl of Consent <br /> I cattily Thal llfn wase ml - swmmem identif�d In 40 CI"217(ay(If I am a Lupe quenlity g rrata)or(bj f am a smell�rantity general0rl a We. <br /> GetneralorsfOlfdolaAflldlJdhT Signormontil Ewy y <br /> J 1+3 In not tYpriteAlS <br /> ww"to US. U E>giort from Iii-S. Pod of enkWexil- <br /> lranspmeersrgrmhne(Ior experts my): pate fearing U.S.: <br /> 17.TrarwporterAdmowledgmerd of Receipt of Materials <br /> 7rarinponrx S PearledlTypad Name <br /> a <br /> ZTransporter 2 Prvdadrlppod Nears Signatere Month Day Year <br /> 1a.Dlsorepaocy <br /> 18a.Discrepancy Indication Space ❑ Quamity ❑Type ❑Residue ❑Penial Rejection ❑Full Rejection <br /> Mmtkfesl N�cronra NMfier,, <br /> 1Ob,Aaemata Facility(or Genemiaa) U.S.EPA ID Number <br /> U <br /> a <br /> u. farilityrs Phone: <br /> LLA 1k.§;ratuno of Akpi4o 9arjlily(Cr reralo TNINd, Ymr <br /> a <br /> x <br /> 19.1 iazardous Waste Report Vznagemant Method Codes(I.It.,codes tot hazardous waste treatment.disposal,and recycling woAma) <br /> 4. <br /> G V+ <br /> 20,Dasga*W Facility Owner or .Operator•Cedlficaflon of ruceipl of hazardous materials covered by the manifest except as noted in Item 18a <br /> PMWTyM Au* 9gnature Month Day 15>ar <br /> osEPA Form BIpl�2?(Rev.3-0S) eADESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />