Laserfiche WebLink
591.. SK SHIP# e2�Fr�I'�I�' ��y8��rl117�2 aKl��w�� <br /> please print or type. >az 5 �� f p� 00 <br /> roml A�Drae d.OMB 4..�/0-0039 <br /> UNIFORMHAZARDOUS 1.t3enam!orlONamber CAL000406390 2' S iPJ OnOs�'a.7 OO72 {711 <br /> WASTE MANIFEST I <br /> 5,Generatnrs Name and tdailEng Address Ganeretar'a Slte Addmas U!difieren!Ulan mal'ung address) <br /> }?iesel Direct WeSt InC <br /> 3861 [?u.1, Greek Dr PO Pax 31086 <br /> f3VX'VT€N CA 9.�?15 795f� <br /> Oenemlar'sAlanp: Sib—E1CS7-1000 <br /> U.S.EPA ID Nniber TlfR000081F'05 <br /> n.rrgr� my 5y5TEM5 INC <br /> 7.Transpmter2 Campa_nq Name U.S.EMU Number <br /> C1.t"Ah! NRHflt]R9 ENVIRONMENTAL SVC INC. MAD0393B2rS0 <br /> a.Oessgnaumf a kyNim and sdaAddress CLEAN HARBORS BAN OSE U.S.EPAIDNumber <br /> 1021 BERRYESSA ROAD <br /> SAN JOSE + CA 951:3 111T1059494310 <br /> r►vlF3—k�+t-0�&ti <br /> Fecil phane' ' <br /> gn, sh.US.DDT Cttjcv ton p1duWng ProWShlWag Nance,hazard Class,ID Number, IG.Contalners 11.Toln1 12,Unit 19.WaslaCalas <br /> and Packing Group(Ii MW) No, Type I apany yyIML <br /> a I. NQN RC;RA HAZARDOUS WASTE 5OLIDSy WSED I)M P 35G <br /> ot- OIL AND ABSORBENTS) <br /> 2. NON-RCRA HAZARDOUS WASTE, SOLID 0M P 2223 <br /> (011- FILTERS) 1-50 <br /> 9 <br /> 4. <br /> i <br /> 14,tialllarVing inslioox s andAdaUoamlinla manor TSD:SJ 7992999D D 596 � CSG: <br /> /1'G4% �-0151 n I <br /> P4H EMERGENCY#800--468-1760—CHfSK/TFI•^Contract retaiy generator annfers agency a hari ,y <br /> on initial trap artar to add r sub t' t i i tra ra tar+ Wha <br /> 15. GENERATORWOFFEROR'SCERTIFICATION:Itarahydeclare MUrecanwbat 0suordgnnwtare Wyand accuratelydasaibedoboverby69proper ahippIngname,and are MusWed.PKbged, <br /> marked and taWadrVecaided,and are in all respards in proper condition for transport according to opplirable IntemalionW and national gWxammenlal regularktna.Uexpod shpreent and I am ft Primary <br /> Exporter,I eerpy Thal the oDntento of ids witAgmmaM amtWm to the terms or Una abefiDd EPAAcknonledgmant of Consent <br /> Itorfythat Wwaste mitbahationslalemanlldonlUiedin40CFR2n2.21(a)(III amalarge outilygererata)or(b) maamalq adygener as. <br /> GoneratoeaVleror's PdnWTd ped Name. Signature Day Year <br /> itrrAb'72i n <br /> 16.Inlowlior4 ShipmAls <br /> 0hapodloU.3. [xpottiranU.B, Partofentrylexil: <br /> TiansportoraTgnsWrg1Wo xMony): Dole le"KU.S <br /> a 17.TrensWrAcknrWcdgmwddReoe119dMatotals <br /> T p I P Name <br /> Trans nnkKllTypad Hama 36grmarre Month [toy Year <br /> C j -0 /Q <br /> 18.Discrepency 11�-11 <br /> 158.Dlscrepanuy Ind'ollen space ❑ct.6tUy L.J Type ❑Residue ❑Parti.1R.*5. ❑Fal 1110*11an <br /> Manigest ReferenurNumUar: <br /> 180.Almelo Facility{a Generaomrl U.&EPA ID Numbor <br /> U <br /> w Fadli a Peons: <br /> inaSl�alureefAUomaMFadiyorGm'amts) Month Day Vast <br /> 19.HaiatdaisWaslaRWndMmagema 99Mctldisposal,and recycling system) <br /> wo 1. z. 1 3, d. <br /> 20.Dasl{lrtaladFaaSry erprG etor.Cedi(ketiglplaxdploi usmatedalsco dbythe mantlasta as roted In ilgtin 1 <br /> PrinleN Nemo nalur Yam <br /> EPA Form 870D•22Toy.12-17 Prav)aused6onsaraelrsateta. DESIGN EDP ITY EPArse•MAHIFESTSYSTEM <br /> 1)763370 /999S'B7 �)761iRVlV)3/15677 <br />