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;ase pdnl er type.(Fo}m desgned forum m elite(12-pildl)rypewriler.) Farm Approved OM8 No.2050W39 - <br /> UNIFORMNAZARDOUS 1'GanerdaWNmn6er 2.Pagelol 7.Fme%enyltespanse Plane 1.Man9esl Traddng Namber <br /> WASTE MANIFEST C A L 0 00 2 6 9 3 7 5 1 (900) 424-9300 . 014051045 JJK <br /> s.CPICKS Name and MalV8'0ss - - Getwelms SikAddress(ddllruwi 6anmakg address) <br /> PICK NPULL #80 <br /> 3927 CLARK DR. <br /> STOCKTON CA 95ZO5 <br /> Ce wsPlane: 209 462-1.927 . . - <br /> 6.TranspoderlCanpanyName U.S.EPA ID NuMer <br /> ASSURY ENVIRONMENTAL SSRAFIGSS - G A D D Z 8 Z 7 7 0 7 6 -_ <br /> 7.TranspoMi2Campany Name _ - U.S.U_16 <br /> iiu <br /> mber <br /> 11 Designaled Fa'ikName and SMeAddrese . . US EPA IDNumber <br /> Dam= /-KEP.D4 IC, <br /> ZD00 N. ALAMEDA STREET <br /> 0074PTON CA 90222 <br /> Fzxiys Phow -(310 537-7100 - - C A T 0-.9 0-0 1 3 3 5 -2 <br /> Us, 9b.U.S.DOT Oexaiptlarr(Ldidsp PrrW&*ptg Name,Itsznrd pass,ID Nu bu, - 10.Containers tt.Total 1L UnXl. - <br /> I0A mdPaddg Giow(Ia4) .. - tlo. Type by 17 Unx 17.Waste codes <br /> 7. <br /> o NOM-RCRA HAZARDOUS WASTE, LIQUIDD - (BRAKE FLUID) 223 I_ <br /> l D 1, v <br /> w z I <br /> w 1 <br /> 3. I <br /> i <br /> a. I <br /> r <br /> 14.SpedN HwAv txtumons xwAdddmal lnfermalm - <br /> MERGENC CONTACT CREHTREC 1-800-424-9300_NAER 9B1 : 171 * PROFILE / 9B1 - <br /> 367682 B FLUID + PO/ A110213781 I APPROPRIAT RSONAL UOTBGTIVEEQUIPMENT . <br /> 15. GENERATOR'SIO OR'S CERTIFICATION:I hereby ledare that Ua mAeXleollhls muignrerd am fNy a - a Ura pmperehlpplig iwro,and ars AsaeCM,pedaged, <br /> maned mW Is andmetratr Inproparmn Roos aoom4sgbappkabb allonal "br�gumi rekhbeed.Ueoatshpnanl endlamBle Pritaty <br /> Eaporlau l sertly1h 1 e mderns Olk matron b Ua w"of eaarhed EP led <br /> lce*Ualgw IknaWanaN h4 CFR2B227(a)ryl: alage gaaMtj abr)ar (XI ma Ia)b bua - <br /> Genaaby _ .�, as - <br /> 0) o . <br /> -� 16.khmatiwal SNpmerft - - <br /> bU.3. ❑Eipart tom U.& orenwe.* <br /> Tmnsperter slgnalue 0a enh) - le leafing <br /> %I <br /> i7-Trenspoda Reodpl Makdats - - <br /> Tr PMkNM)yad Nana . - <br /> ! SlgaWre FIonN <br /> O Dayq Year I <br /> 2h TrampMerz MnasYTyped Nana d !f !ea <br /> - � Sgriakfire MmOt - Day Year I <br /> T18.DIweparey - - .I <br /> tBa.Dsaeparxy tdka6m Spam ❑Quan6y ❑Tw. ❑Res due ❑PawlialRak Um ❑FW RepaEm <br /> =I iBb.PAerrak Fedily(aGercmlor) Mariksl Reference Number I - <br /> US.EPAID Maher <br /> Qti 1Sc.Sigmtfie MAkmalaFaoMy(mGererdsr) - - - M" C" Year <br /> 19.HaZestim Waste ROAM Mmagenenl M611W Codes p.e.,codes for hazardouswaste teasnat d Vo*aMrig systems) <br /> 0 1. - 2 S - - A - <br /> 20.Dmduled FacRy O,maOpardor.CKMa6yrolrerel dhamrdaam*nalswsNdhy9a ma�estmmepl asnMdh Xem iSa —. <br /> jIf <br /> .' .. _ Way?--.-: - .-..Day wr <br /> EPA6=8700-22(Rev.305) Pmvious editrons are obsolete. - <br />