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{orf'., •J .-�, �. .-� V .; 1 rF.� .. - ... <br /> tsNi <br /> .Please print or(y e.-(form:des1gne4for,,useonellte.(2'tbh ewr(ter.) Form Approved.OMB.No.2050.0039 <br /> UNIFORM HAZARDOUS 1•Generator ID Nwer ; 2.Fa to 1 of 1.3,Emergency.Response Phone 4.Mapifersst Tlraacking Number <br /> WASTE MANIFEST': 'a:Ai) 7 .10 1 .�. . t ?c' ig8 .I.J T7 318 JJ K <br /> S.Generator's Name and Malted Address 3 Generators Site Address Of different-than meling address) , <br /> ALMIROM IKU TPt ie'f[l hVY MOPE- ' <br /> .11316 NA'dX:il'JI: �: ,,w ,,►. . <br /> .s'" mu_ BTtaGK FtlNe� CA X2+76 OTOCKTON OR- 252-5 <br /> M•QafieiatorPhone:::1.1-209.iKfr�yV 107 - <br /> B,Trmas20 far l Caripany Nam& U.S.EPAID Number <br /> E'KifiRONMENTi IRECOVIB BY 60RVI0E!ff,NU0-. C A RD s I1)10 0 2 0 1 <br /> 7.Transporter2 Company Name U.S,EPA ID Number <br /> 8.Dssfpnaiad Facinly Name entl 3geAddress U.S.EPA ID Number <br /> W-ECOLOGY <br /> _14WY 2F;1a MILES BOIJT H <br /> BEATTY - Rid L <br /> FacMI es Phone: ' ( ^22fJ9 11 V.f t n a 4 n <br /> 9a. 9b,U.S.DQT Dsscriptbn.(ktduding Proper Shipping Name,Hezerd,Claya,ID Number, .. 10•.Confelnam.•,,_.. .- 11.Total 12,Urilt ' <br /> W and Parking Group(Natty) ) No. Type Quantity Wt 19.Waste Codes <br /> a 1' NloN RC WF IAZAFQOI.lS WA6TE.A.I Ut)(OIL,aE tIr2) + , <br /> W <br /> h D IN '•' ° I° (� �' ~fes <br /> 3: <br /> A:- , <br /> 14:Special Handling kulrudkme'andAddleodal lnkxinaeori <br /> SB41p9i)1SDU 10it+!)'•E)IRNA+FiUfdENCfz�B.YI ' w�''!,�Esr• :EtRCddi;fa91.17i;913�:i7.1 #• lfil.0:l�iEh`It$t1-ECL°¢ <br /> 9 �1t1711i' JOf1 116@=$AhlDtewrrolmiY <br /> '24158 E!UIMEA CY CONTACT:EJ+N ROSERV <br /> 15.''GENERATOR'StOFFEROR'9 CERTIFICATIOW,I hereby idem that the sInhintit Sf lfils•conslgnment are Uy sed aocgra(*dsacdbed ebove.by fhp praper.shippingname,arxtare deasI led,packaged,. <br /> marked and labeled/pSayarded,and ere In at respect M proper condition for transport according to 81300 ble International and nellanel governmental Ngulatlons.If export s4ment.and Lam the Primary <br /> -6i 001101.l ceitlfyfhat thetpntente of this cbmiignment cohforin to the terms of the attached EPAAcknowledgment of Consent. <br /> I car*that the Ylaste minlmiraton statement Identified In 40 OFR 282,27(a)Of I•amia large quantly generator)or(b)(III am a small quah*gerisrator)Is We. <br /> GeneratoeslONerors Pdn%Cyped Name Signature ' Month ' D Year <br /> a 18.Inlemetonal Shipments <br /> F- El ii*rt Io 115. ❑Export from U.S. Part of erdry/enli' <br /> Transportersignahxe(far expods'only): Date leevkhd U.S <br /> 11I.TranspollarAcknowledgmentof, ecefptofMlatedels' qa <br /> Tmnspbr�ei 1 PdmedR ' shier"' f Signature ;? Month Day Year <br /> J.z �'rgnspq er2Ph_nted/T adN r� ��� " <br /> YP .Ptna Signature 'j L Month Day gYeal., <br /> 18.DIscreaficy. <br /> tea Discrepancytndloeton space ' <br /> Quantty 'El Type.- []Residue El Portal ReJectian ❑Full Rejection <br /> 18b Alternate Padtty*eeneretor) U.S.EPA ID Number <br /> ManlfeslReferetice Number. <br /> u Faclltly's Phbne <br /> w 18c.Slgfiletbre ofAkematd Fadllty(or Generator) - Month Day .-Year <br /> Z ... ' �.. .,. . . . .. <br /> :19.Hazardous Waste Report Management Method Codpe p.e.,codes for hazardous-waste beahnent,disposal,and recyclingsyatems)., <br /> p 1, 2. 3. 4. .. <br /> 20.Designated Paclity Owner or Operator.Certification of receipt of hazardous matetlals covered by the manifest except ab-holed In Item 18a <br /> P elle ype Name Signature Month Day Year. <br /> EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. I GENERATOR'SINfTIA).COPY <br />