Laserfiche WebLink
SSL SK SHIP# 233324653 IIIIIIIIIIIIIII���IIII�IIIIIA <br /> 007576979 S KS <br /> Pleaes print or type. Form Approved OMB No 20K-0039 <br /> UNIFORM NASARDOUS ' C atalDNu"'be' CALM392916 2Page1l of 3fE,�@'-"L'6�-I�0 a.wnH.et rracklnv Namlrer <br /> WASTE MANIFEST 0075769 9 SKS <br /> 5.Generators Name and Matli Ptltlres Generators Site Address(it disarms Nan llrg address) <br /> O'Reilly # 3501 <br /> 515 E Yosemite Ave <br /> MANTECA CA 95336-5037 <br /> Geraddi Pyha�nyd��r�n 20,�_9a-239-41BB <br /> e.T 11—ITLTn SYSTEMS INC Us.EPA IDNumbar TXROOOOB1205 <br /> 7.TansltMer 2C4mpan Name US.EPA ID Numbar <br /> CLERN lXWBORS ENV SVC INC. MAD039322250 <br /> e_oeeiy`amd Fatiip Narsead SdeAdddass CLEANHARBORS OF BUTTONWILLOW U.S EPA ID Nwmmer <br /> 2500 LOKERN ROAD <br /> BUTTONWILLOW , CA 93206 <br /> 661-762-6200 CAD980675276 <br /> Fedor s Plane <br /> ga M U S.DOT Desamptwnlmdudinq Proton sh,urg Name.Ha( rs.paID NurtlRr. 10 Come am 11.Total 12 jou <br /> NM and Packing Group(if any)) No Type Quantity W,`mI 13 Wants can. <br /> }IBME <br /> —RCRA HAZARDOUS WASTE, SOLID DM P 181 <br /> o 7s§BENNT AND OIL), 4"47. ' Q \ 1 <br /> � t <br /> da <br /> w <br /> 3 I <br /> A <br /> d <br /> 14.Special Haddlirs Instructions and Adddlonal information TSD:BL 85244041 DR14365 CSG: <br /> 24H EMERGENCY#800-468-1760—CH/SK/TFI—Contract retained by generator confers aggency authori y <br /> on initial transporter to add or substitute additional trans orters on enerat or' s behalf. <br /> 15. GENERUMNO GFFERGR'B LERDFKATpN: IUaepy dxiare mal Ve mnlenm of mm mr�sgnmenlare NllyaM ao-vrat&y eesoi0ed aporx by Ne proper skpgrg nartre.aN are daesified,paGaged. <br /> mamx add Upeeeddamrdad.and are in d1l respeck m Voper mrAicm b Uanspa�ammrdmg tpapplraHk mlem3HTalaM nauaal prvrpnm¢nedl reguMoan.H e>aod snromem ad I am me Primary <br /> Eapoder.Iremit'Nae memnesnla ofad en,wer l in <br /> 41 Sip Mleans of aped,arge EPAA Fmmmumenent 11 Consent. <br /> redly Nal Mre waste minlmlzaliw statement dentMletl In 48 LFP Zfi2.Pfe)Pllamalarye quantlry geneamp or @I Qflemas IpuenUly eatals true. <br /> GercrabySd011ttp's PrmlM Name Synature MmN day Year <br /> e <br /> 16 Rummaged$M1ipments ❑Impar U5. ❑Exporlfrdn US. PandfuntDreat _ <br /> S Transporter syrewre for expand;only) mmlean Us <br /> W 17iagq@rPO gM rgdt W decades of NdRvls <br /> ¢ mransparle 1 �edd(fyge]N SgnaWre Month Day Year <br /> 1 IL I <br /> I T2mspadtt deans,, ped Name SgnaWre FbnN DaY Year <br /> 1 Iasi L 2 <br /> 18.Dlxepancy <br /> Me D9O0rem'Y ptlucimn 5came ❑ Quanmy 1:1 Types ❑Nei ❑PamN Rejaem ❑Eunaelmwr <br /> Manisod Solutions Number: <br /> IBD.superseded Fact dor Saudi US EPA ID Nomber <br /> U <br /> u Fadlitys Poona'. <br /> can IN,SignasmadaAternsts`mmc dr Gereatal Monty Day Year <br /> Q <br /> Z <br /> y19.Hazardous Waste Sepon Managamanl MaMdd Lddesi.e.,codes for narardous waste VeaMene.disposal and recycling syslemsl <br /> IN 1 Is <br /> 28.Deeignalad Fanpey0wnarorD or LedlHfeaon ofrexiptMNzardoua malenala mvered by Na mandeat exmplaa nuM�n Item l9a <br /> 1 Pnn rrrpod I9nal a Month Day Year <br /> a <br /> EPi�o s edifibi are species DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />