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Pleasay'ripLot-Wo. (Farm deslanad for use an elite (12 -Ditch) Noemiler.) . , cam,.., A^ --A nam ku, an,m nnon <br />�, ..1 min vs w -<n knuv. a -vol rouvious Damon are oosoune. DESIGNATED FACILITY TO GENERATOR STATE (IF REQUIREb) <br />UNIEOPMHA2ARDOU5 <br />11. GenerstorlDNusnZ {:: <br />2. Page l of <br />3. Emergeary Response Phone <br />4. Man Real Tracking Number <br />WASTE MANIFEST <br />C A L 0 0 0 2 5 9 3 7 5 <br />1 <br />800 424-9300 ��- <br />009894957 JJ K <br />Spenerotore Name and Mailing Address <br />PICK N PULL #®0 Generators She Address (d differentNan mailing address) <br />3927 CLARK DR. <br />STOCKTON CA 952,6 <br />cenemtors Phone: Z9 482-192.7 <br />6. Transporter 1 Company Name U.S. EPA ID Number <br />ASBURYENVIRONPdENTALSERMCES C A D 0 2 8 2 7 7 0 3 5 <br />7. Transporter 2 Company Name U.S. EPAID Number <br />S. Designated Facility Name and Site Address U.S. EPA ID Number <br />WINC I KERDOON <br />I. AL EDA STREET <br />CMPTON CA 91'JM C A T 0 8 0 0 1 3 3 5 2 <br />Fadliys Phone: 0101,07-71CO <br />9a <br />91s. U.S. DOT Description (Including Proper Shipping Name, Hazard Class, ID Number, <br />10, Centel <br />am <br />11. Total <br />1ZUnit <br />UnitW. <br />HM <br />and Padding Creep(d any)) <br />Quantity <br />. <br />W. <br />13. Waste Codes <br />No. <br />Type <br />0223 <br />1- <br />1 <br />NON-RORA HAZARDOUS WASTE, LIQUID (cRAkE FLUID) <br />yr <br />5-0 <br />� <br />Ll D,i <br />G <br />z <br />2. <br />w <br />i.7 <br />3. <br />4. <br />14. $pedal Handling InsbucVere andAdditional Information <br />ENERGdE1`ICY CONTACT: CHENfFREC I -ECO -424-M NAER134981 : 171 'PROFILE #981: 2813M 6RAKE FLUID • PC4 <br />Al 101t54C94'APPROFRIATE PERSONAL PROTECTIVE EQUIPMENT <br />- ixs-s' <br />15. GENERATOR'SIOFFEROR'S CERTIFICATION; I hereby dedare that the contents of Ude consynmenl are fully and accurately desmbed above by the proper shipping name, and are clasafied, packaged, <br />marked and labeled/placarded, and are In all respects In proper condition for transport according to applicable intematonaland national governmental regulations. If export shipment and I am time Primary <br />Exporter, I certiy Thal the contents of this consignment conform to the terms o(the alladied EPAArknoMedgment of Consent. <br />I cert"I the waste minimization statement Identified in 40 CFR 262.27(a)(if I am a large quantiygenerates) o%b)lift am a anmAquantity generator) Is We. <br />GeneratorslOHerors PdnteNFypad Nemo) r-� M ' J Sq - Nie rx._� a y( _ ( 1, _ , M� Day_ Year <br />(// rj j1. -ice/ <br />18. International Shipments <br />❑Import to U.S, ❑Export lrom U.S. Pod of entylexit: <br />Transporter signature (fat experts only): Date leafing U.S.: <br />w <br />17. Transporter Acknowiedgmenlof Receipt of Materials n <br />7r of 1 P tecvf d No Signature ' Man Year< <br />- <br />z¢ <br />7ro spoder2PdnleQRypgtl ere SY�ae re Month Day Year <br />(/ J� <br />Discrepancy � <br />t18. <br />18a. Discrepancy Indica6an Space ❑ Quantity ❑ Type ❑ Res cue ❑ Partial Rejection ❑ Full Rejection <br />Mandesl Reference Number. <br />i8b.Allemate FacTy (or Generates) U.S. EPA IO Number <br />U <br />LL <br />Fadliys Plane: <br />180. Signature ofAltemale Faciliy(or Generator) ManN Day Year <br />a <br />z <br />y <br />19. Heaardous Waste Re Management Method Codes a codes for hazardous waste treatment, disposal, recycling systems) <br />pod ag fie., poral, and re <br />01. <br />2 3. -T- <br />20, Designated Facility Owner or Operator. Certification of recelpt of hazamoup mater als covered by the manliest except as noted in Ilam 18a <br />PMI yped Namegna re— Month Pay Year <br />J <br />�, ..1 min vs w -<n knuv. a -vol rouvious Damon are oosoune. DESIGNATED FACILITY TO GENERATOR STATE (IF REQUIREb) <br />