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Please prim or type.(Ford designed form on eme(12- adt) pewnter.) SIC PPW 7/12/2016 Fan Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS1.GenemmrlD NO <br /> 4Page im 3 Emeryerry Reponse 1. a.Want That Number <br /> WASTE MANIFEST CA L000359102 1 (900)453-3719 101197,4320 FLE <br /> 5.Determine Namearb Memrg Address Getlmamratate ren Nd ramiouramiNedinat <br /> DTE Stockton LLC <br /> 2526 W.WCaAshh5intittinn Street 2526 W W ashird t ra S~ <br /> S 9tiM,.(2IRN-3700 ATTN:Genne Huffman 9tockton,CA 95203 <br /> r:remmra vnpne <br /> mmoMr I Germany Nam U.S.EPA IO Number <br /> faro � N <br /> 7.Tmmpoder2 parry Name U.S.EPA IDNumaer <br /> r <br /> Desgnatue Fatiiry Name and 6'ltu Adtres U9.ERAIDN«Nler <br /> Clean Harbors BuuOmMillow LLC CAD 5 6 0 6 7 5 2 7 6 <br /> 2500 West Lokern Road <br /> B mrillow.CA 93206 <br /> Fais <br /> 9a. k..Us.D Deeayaion(iMWxg PmpmSwwm Nate,meridCase,ONu erns. 10.Contuirem 11.TWI 12,Unit 13.WeW Codes <br /> HM mdpeo mGmio(Knon) No. Typo Duane, WTNd. <br /> fe1'UN1759.CORRDSIVESDLIDS.N.OS-.(ARSENtC.CHROMIUPA A 571 <br /> 1.X S.PG 114.(BDI7OMASH) ! LI �`IV /— <br /> z 2. <br /> our <br /> I � <br /> td.sparial Hanmire msmtmmas and AfANaml lineament <br /> t <br /> 1.081346360 13260154 <br /> Contraot retained by generator Confers aaenCv autR001Y on Inbul Iran ciorter t0 add or Substitute 3600n0I transoOnels 00 aerMrdOr6 bebair <br /> 15. GEHERATOR's10FFEROR'S CERTFIDATION: Thereby dedeamelmemmmtm Mmbansgnmenlare mlhatb afLu2rely desrnbetl aboveby tlmp persNppirq twre.adare Naa4rMl,DarkA3ad. <br /> maned and and are in an raspens in pmear mpdmdn or imnsppd memo,to appenew international and mwnal wommenml institutions,ifaut am em the I em am Ptmery <br /> Eapodee. mNh mat de mnlenm of m5 mnsgnmenl mnl«m m Inn turns M ma aaametl EPAAcxnorded9menl pf Cpruml. <br /> I mail,that the waste minninuaton stammer doi In 40 CFR 2622oa)(al amalarge quart,ganamer«(bl(dI amamall quarry gammb0isma, <br /> rHaIWL mor notedread igra m Y Year <br /> �v q Iso 2L) <br /> t6.lnmmareaal Gbipmee <br /> L Ljmi.u S LIENdonamet ns Pon erY s <br /> � Toersi nature for ee rts onl Dale lenui aUS.: <br /> K 17.Tmnsp«br A,M dgmanlol Ramp)of Maretxb <br /> OTN9 n&1Pnnfulood, D, aY. <br /> '✓1 g ro <br /> K imrepodua lin ,,d Name aiment ey ear <br /> H <br /> 1 tans Dente," <br /> 19a.D,.W,lndom E]ao,Some, Daamt, ❑Type ❑Reb ❑Paftal Rp tim ❑Full RepaBm <br /> MaNbn Reavenm Numbar <br /> Not Alemma Foray for moon 0 U.s.PAID Number <br /> U <br /> LL Foal ePKm: <br /> w lac.siolawemAltumW Fadliryl«cemmla) Manor Dar, Year <br /> a <br /> z <br /> y19.Hazard«ls Waste Rep«IManagemenl Maamd Cpdeali.e.,orae Por tummowwnte maanant mspoal.ted temnng sysbmsl <br /> o f. 2. 3. d. <br /> H132 <br /> 20.Degreted Faaliry sorer«Dpereror.CenMotlon Areugtolharardouamamreb caretM Lyme mmltlest eamplasrotW in Item 18a <br /> 1 PrrWyped Nam achieve< be Yem <br /> ri IoV o8 70 <br /> EPA Fmm 8700-n(Rev 3-05) Previous Woods are obs0lele. DESIGNATED FA ILRY TO DESTINATION STATE QF REQUIRED) <br /> Clean Harbors has the appropriate permits for and will accept the ea a the genera ton ss snipping. <br />