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Grit'. SK SHIP# 2MS2104 <br /> 006961340sKS <br /> Form Approved.OMB No.20590030 <br /> Pleasa print oflype, <br /> pN <br /> UNIFORMHAZAR00US t.Gerteratatumber CAL0000150313 ZPage io1 3 4.FmergQrwyft pOna9� � ManifestTrackingNumhar SKS <br /> WASTE MANIFEST 11 rt55 YY7) ItEE�7 <br /> 5.Cseaeralors N.ime and Ma3lnyhddress Genemwq Sire Address(if dipelanl Ihanmshlrg address) <br /> San ,J;aqq!tirt Ca Maifitenance <br /> 1Hisn H#I:e1t0FI I <br /> ST17I Y,'(014 CR 9:12Ss;�-E232 <br /> Ganarators Plw•s: '.�. "y168—iQlt7 U.S.EPA ID Number <br /> 6.Fran r i..an Namo Tl(I2000419 k X05 <br /> SFT(-LBEN SYSTCMS INC: <br /> 7.A sgorler2Comp 'Nam <br /> U5.EPAfO Nim-Mr <br /> 5 <br /> 3 <br /> . .EPAlO Number <br /> _ U5 <br /> 'IA Naas and 3de <br /> Address <br /> i'. <br /> e.pes bated Faa y SAN <T(I sl. <br /> is N HARBORS rl��a , <br /> 1081 NERRYFSSA ROAD (,� 951,E 3 <br /> SAN J053 , CAD059494310 <br /> yFt�lB--4ta1-•0�16�' <br /> Faad sPhane� <br /> 10.Canlalners t},Tn161 l2.Unit <br /> Kobe?, s <br /> d Na".Ham <br /> N Class ID Ntrm 13.waste Cala , <br /> indrad' Aro SF <br /> .U.S.DOT 0asrn non a9 Per pP�nB <br /> 9a. 9b p ( No, Type QUardty YlINd. <br /> 'n G!o� dab• <br /> and Pa.Ya � ( 1) <br /> HN <br /> 9 P ) <br /> 1' NC•N-RCRA HQAR0OIiS WA""Irl GO"') � DM !JF� t, `r <br /> o (fill. FILTERS) <br /> z 2. <br /> {�7 <br /> 3 <br />�r <br /> 14.SpedalHardinglnstructionsaWAditioneltnlamaaan TSD SJ 80114133 EtA-',2680 C96 '. <br /> 0`a- (a�iU��L3 � <br />'4 <br /> 24H ,,5pGFhl1:Y#800--46A-1760-CH/5K/TFI-Ca"tr'act retained by ger,tI confers aeT1c y authpri .y <br /> 111 11 111 J. <br /> 4 15, CENERATOR'SIOFFEROR'S CERTIFICATION:I1,eieby declare that dw COoleols of Nus conalgnment sue refyand aoouratery 4.-,W aWl-by the proper shpplrg name,and rte cttssifred,padsa0ed• <br /> marked and tabeledlp'IOCarded,and are'^ail raswb in proper condlI fav trompal aomid'In0 to eDpFtabb rtamafonal and rtalional 9%1YOPOAlal rcotftons,If eapod s1f pn70n1 ond!am the PrimaH <br /> Esparta+,I Certify(hat the conlenls o€Ibis consl�atent Conlonn to t€le terms d Ilse aPa[Aed EPAAcknardedgmonl a1 CenseM� <br /> Ict'Iily anal lhowas�A minirnizaliatistalemant idenli4ed in 40 CFA26227(a)(if lama hFgequantily gernrala)a(61 G11 amasmd gdanUry genaraSar)Is In�O- ✓ �af <br /> Generatorslo'faoes PimAllyped Name Sgnalu <br /> 1S,Inlamaadn:A Sh'Pracnl Impart to U.$. ❑FxP-4€rein U,5- Podof enfiylayit:_.,_.,_...._._..._ <br /> ? Franspodasip+salura(loreaponsdaf p• Malea*gl}.5.: <br /> 17.TrampoderACkrowledgmentalReca�plol6ralcdals � W 0a JYear <br /> Ra .erl'intt¢ 5'4natam <br /> A+.onm nay veer <br /> Name <br />'€ iB.fYsasparcp �j <br />[ l8d.pisGaparwrylnd�;ationSpace CII ❑TypYr ❑RnsAoe L....IPena€fie;action ❑FvllRe(eCam <br /> MI Refafence Humber. <br /> U.5.EPAIp Number <br /> f 18h.AlI mRtc FBON IN Gata81,011 <br />€ i4i Faraigrs Phcna: Month pay Year <br /> 18c-5i,Pala•ocdN4emaloFacady(arGeneratoll <br />{ <br /> pose ecycM:ngsyatems) <br /> 10.Hazaido�is Was R pa€Ma errenl lAetltod------i.e.modes4a neisttim>S waste eeaLrranl,dis I.aMr 4 „'.. <br /> E ur <br /> is <br /> 20.01 5igna'ed raeftg a Operate: erbfiwC receipt of hazaldaus tea€eria€s cn+aed b/lhamandestapcePt es rxiod In)lath 18a �TOEST <br /> `prinfedlSyPr-d Na neEpAfam07002z�Hd3ESIGNATED FACI1101 <br /> LSTE <br /> i]751-'-40.,/i 5777 <br /> - _ - - - - - - - - <br />{ <br /> i <br /> E <br /> i <br /> I <br /> E <br />