Laserfiche WebLink
Please print or type. Form Appmvetl. OMB No. 205P0039 <br /> UNIFORM NA2AROOU3 i. GmttadriO NUMer 2Pepetd 3. Em ryfteaporee Phone 4. Mann Tracking Number <br /> WASTE MANIFEST C A L 0 0 0 2 6 3 7 9 4 8001344-9513 019 3 7 6 6 5 JJ K <br /> IGTIEwmrew.ltg"IrT%ARLEY COOLING T044ERS �ms Slta Abode lnaiflerentman mauire waraeae) <br /> 2170 N]RTH IAINGNERRA E. <br /> STOCKTON CA 95215 <br /> Campbells Phone: 2 0 9 4 8 5 - 3 4 5 1 <br /> S.Treea22Merl Company Name U.EEPAIDNumber <br /> b✓tF' Enooronmental Eervicee n. T 0 0 0 6 2 4 2 4 7 <br /> 7. Tra emelt 2 Company Name U.S. EPA ID Number <br /> e. °N%ell M. TIAGEMENT - KETTLEMAN HI US. EPAiDNummr <br /> 95251 SKYLINE ROAD <br /> KETTi EAAAIJ CIN CA 93239 <br /> Facill" Pnme: 599 936 . 6200 C A. 7 6 0 0 6 4 6 1 1 7 <br /> 9a. 9E US DOT andipBm hicuding PmperSNpong Name, Hand Class, ID Nume,, 10. Dammed 11.TMal 12 Unh 13, Wald Codes <br /> HM and Paling Gmup (danyll No. type anyway NMI <br /> T fqONRCRAhAZ7 .R'Du - 181 <br /> o <br /> CM 30 Y <br /> as Z. <br /> 3. <br /> 4. <br /> 14. SI;"al Handling Imenckow aid addl llnbrmelbn <br /> Appropriate NEE Profile # IZA615455 <br /> Filter Cake containing chrome tic <br /> 15. <br /> 1 se V <br /> 15. GENownedandla 810FFER0Rd, and amh hall <br /> ytledammdtlre wdenbdab ing W sentare ally maonshun lyticaaibea ab MIpiguldby Me on Mppngdounck al so I am M. managed <br /> Expand StN Mlplacardetl, andareball reapeM In pr0parmMltlon fa trampodaaedFA cappllcag iebmagmdem nelbnd govzmmeMal repulagms. gexpod sNpmenleM am me PMrery <br /> ExpoNeOl mNty mature mmenddmdmnelgnmmlmllam btlrobmbdgeallubM RPAAcknodMgmenlolCmeml. <br /> I remymalt5a weal minimbatlon sadmanlltlanMMbd0 CFR 282.2T(a) (Nlamakrpequa+tiry generaWr) or(b) (ifl amaemeN quaMltygereralor) ie We, <br /> Gemerdwa0be is PrinbMypM Name Spnature Mal Day Year <br /> Del <br /> in . SillyL ii � q <br /> 16. Intemallan A mmb D ❑ ImpM a ❑ ExpMM1am U.S. Pal d enbylpxit'. <br /> Tranedcar dgnaura (br enoms only): Date leaving U.S.: <br /> W 1T. Palawan Ackaboadedgmens d Reoiipl 0 Measle <br /> KTeanspMo 1 PlImedrtyad! Name S4mm Mmm am Year <br /> by �N o 1 25I <br /> ranspoder PrintedRypetl Narz sunum kbnN Dry Year <br /> t18 Dsurepai <br /> B p ❑ Dui ❑Type ❑ Residue El than Repctien ❑ Pd Reallon <br /> 1 Drape Y °eG Manned Redrerce Number: <br /> mb. AlarnaleFecllipda Genemd0 U.S. EPAIDNumber <br /> u Fadllty's Phone: <br /> aha 16c. Signaure of Made Fadlity (o Spaceman) MOM Day Year <br /> HT <br /> 2 <br /> y19. Hal Wass Now Managamml MemM pompe ga., wtleabrhamrdouaweld treebnmldeposal, and recyNbg eyabma) <br /> wO 1. 3� 2. 3. 4. <br /> 20. Design ded Pal Nimbi Deareur'. CeNfice4on of rem¢t of heuNws madriala corered by me moment doapl as Metl in 14m 1B <br /> 1 FrinlMRype NamoneuYear <br /> EPA Pon 8700-22 (Rev. 12-17) Fmmus eeiba arobsolad. UDESIGNI FACILITY TO EPA's e-MANIFEST SYSTEM <br />