Laserfiche WebLink
eleam print or type.(Form designed for use on elite iD itch ewnter. Form A roretl.OMB No.2050-0039 <br /> UNIFORM BA2ARDOU8 1.Games"lD Number 2.Page t of 3.Em;Orn,Raspone.Phone 4.oarraslTrawarINumber <br /> WASTE MANIFEST CAL000400167 1 (800)424.9300 017696499 JJK <br /> 5.Gementems Name antl Mailing Mdress Generators Sial Mdress(if parent Nan mailing address) <br /> SPEEDEE OIL CHANGE&TUNE UP-GRANTLINE RD <br /> . 245 W.LOUISE AVE <br /> MANTECA CA 95336, 71'-W <br /> 1WGRANTLINE RD <br /> Generators Phone: 209 8361557 TRACY <br /> TT-,PW,l Cdnpwny Name US.EPA ID Nuaabar <br /> WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7.Tmnapomer2 Company Name Us.EPA ID Number <br /> WORLDWIDE RECOVERY SYSTEM INC. CAR 0 0 01 7 5 4 2 2 <br /> 8.Deemaled Foah Name and SM Access U.S.EPA ID Number <br /> YUMA YES LLC <br /> 2730 E 13TH ST <br /> YUMA AZ 85365 A <br /> Fadll Pbone: ZROOO515924 <br /> g¢, 96.US.DOT Dooda8on broom,Prepay SNpping Name,Hamm!Class,ID Number, 10.Goalme 11,Total 12 Unit <br /> I-M ad Paling Group(if ary)) No. Type Cummy yri 13.WasW Codes <br /> 1. NON-RCRA HAZARDOUS WASTE SOLIDS(PAPER FILTERS,OILY / /Z <br /> SOLIDS) DM /`D P 352.._. ...__.. <br /> i 2 <br /> W <br /> 3. <br /> 4. <br /> 14.Special reMI'Irg Iratrimsons and Mdil'xmal InWrmagon <br /> EMERGENCY CONTACT:CHEMTREC 1.800.424-9300 WOES TERMINAL:CERES CS *PROFILE N 951:162623NRSSPE099 <br /> OILY SOLIDS,PAPER FILT * *AP P TE PPE EQUIPMENT 2eZ�o / / �•s <br /> 15. GENERATOR'SaGFFEROR'SCERTIFICATWN: I beriberi enable,contenboftibeconslgnnlentareWllyard accurately tle,ei above bythe perpershimm,name,andamusesised,padaged. <br /> 5v antllabel¢Nplthe who aM aretoallregnmen In papa to me on ImbenspomacmMng Wappllfebla inlemationeland natrenal govazmm�ntel r¢gulaAons ll expor fiipment antl am the Pdmary <br /> &goner, salty Ibet the Wnients allrisaneignment conform to me Wrmaof Na atlacnetl EPAMknmNWpmentof C <br /> I certify,Nat the.,,.minimization sWWment dividers,40 CFR 282.2T(aI(Illamalamen uantity ganmatop or(b w cllqua fton <br /> is lme. <br /> GmaraWlalOBerol rintemen sd Nana EignwWre Monh Day Y.. <br /> G <br /> 'r 16, chwastames Shipments <br /> Trenspmeraigralure(tor expode.10: Data <br /> to S. ❑ExporlfrmmUS. on MaMrylexq: <br /> YI Dare leaving U.S.. <br /> W 17.TrdnspwkrACYnwkdament of Rareiq of Muni <br /> yr Their Carl Pnrned4Rypatl Na me Signalum Month Day Year <br /> Dj 11711P <br /> < petl Name Sign Monty Day Year <br /> Ir o v <br /> 1ae <br /> 1 LI ! <br /> rDepanry,Dtecrepency hamewilsaws, ❑ Ouantiy ❑Type ❑Residue ❑Padial Rejection ❑Full Rejeglion <br /> 4 Maniksl Rich c nw Number. <br /> T b.NWmale rangy(or Geraratorl U S.EPAIDNumbar <br /> J <br /> U <br /> rQi <br /> Frei Phone: <br /> p 1&.Signature mAaemas Facility(or Geral Month Day Year <br /> z <br /> N19.HdUNOus Walla RepMMaregemact Method Come pa.mi for bazanbus easle lreatment,deposal,and recycgrg syecrs) <br /> We L I 2. 3. d. <br /> 1 20 Dnig atotl Fa MyO apOpemfm Cm BgadoredptINM1auNaua maW la co eretlb ttam n8eetem ndW in IWm 18a <br /> P'WNTypetl m SgreWre Mand, DaY Year <br /> 2 t <br /> EPA Form 8100-2 (Rev.305) Predous editions are obsolete. DESIGNATED FA ILI V TO DESTINATION STATE(IF REQUIRED) <br />