Laserfiche WebLink
ExpertSUST WABOUI <br /> Land Disposal Restriction Notifmation <br /> GanaraprName, OaCeMOMy#177 EPA Number. CAt0pG�i+ 5 <br /> Generator Addr S: 1120 E_Hamrrw Lana Stockton,CA. <br /> Manifest Tracking Number: 0136192127FLE <br /> 1ns&uGfr*ns <br /> Column 7r List the Manifest dine number or Ili wifpSt 1,ene ije�m- <br /> Gol:umn 2:Identify$It U.S_EPA hazardous Waste GcOm that apply t4 this stipment_ <br /> Column 3:Choosethe apprcpriatatroatabiility group.NoTi VWastvwatar(N MtW)ar Wastewater('MM}. <br /> Column 4:Enter the appropri2Ae SLZoalegory(per 40 CFR 268.40). 4 applicable.and also enter"C-antaminated SoF or Debre if the waste will be <br /> treated using one Of the altema0ve tpaabner t technologies pnmic)ed by 26&45(c)-scd.or 2M.45-debars. <br /> �;olumn 6:E-nW the letter of the ag3QGOt]li3t 8ragrsph fmrn below(see Ap0end"u i for other op6arr5 V needed) <br /> C*Iarsin 6-For F001-17005r pkease enterthe Rafwencs hiumher(s)Iacated belmu far the conetituente,in year waste strum sr�h�ect tntr neait. <br /> Cofurnn 7:Far F039,D001•❑C43, Debris&Contaminated Sail:please list the Reference Numbers listed in Append5t 2 for any Unde€lyft Ha¢ardoa.is <br /> Consfittrents_ <br /> check One <br /> Regulated Umie-dying Hazardous <br /> Mmi[est t-wre N U FPA Heu�n ous F Eae�Must This L Constikuerb <br /> or miles#k.iee Item Waste Godes Sub-Category Was*Ee or F0Q1•r�tucnts fCr D01'1-ID043, <br /> Nf�!�l4� Managed? For 005 ❑ebris or$0 <br /> �V',�i <br /> Coturnn 5 Waste Management Codas <br /> Gotumn 6 FOCI-F005 Reference Numbers <br /> Cofumn 70001-Q043 Referenco Nurnbors <br /> I hereby cenNy that aW information subscribed at this and ata associated d&-umen%is cornpte€aand accurate to-hc best of my knmvkxw and <br /> info matian. <br /> Generator Signature 11 �`� -� ��. �-�i� TilJw <br /> Printed Name: #4R{ j a #c}u_ Data: <br />