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1.Generator Ip�Numb�er2.Page 1 of 3.Emergency Response Phone 4.Waste Tracking Number <br /> NON-HAZARDOUS � -WASTE MANIfE5T t 7 -r�.. Y 9 <br /> 5.Generators Name and Mailing Address Generator's Site Address(K different than mailing address) <br /> ur i1-ie3r:IW£i:Sul1T'1 Aircoet`S <br /> A11rt: Pal Gd*a t-*1'tr, 5200. heft&Steel' 1990 pi=4 Stockton d <br /> Co. <br /> nwnerce CA 90040 <br /> 95215 <br /> Generator's Phone: 32`4 U.S.EPA ID Number <br /> 6.Transporter i Company Name <br /> � T 0 A r 'i rhe <br /> i-4' klat'Tralls <br /> inc U.S.EPA 1p Number <br /> 7.Transporter 2 Company Name <br /> U.S-EPA ID Number <br /> 8.Designated Facility Name and Site Address <br /> ATM E, BRUMOACRE LASE <br /> BAKERSFIFLO CA 93207 <br /> Factl' s Phone: ^ <br /> 9a, 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 1o,Containers 11.Total 42.Unit <br /> HM and Packing Group(ii any)) No. Type Quantity W1 Nol. <br /> a 1' N = I-i AF7s`C?US WANE i,l9+lil7S. <br /> Lu <br /> uzi 2• _ <br /> 0. Special Handling instructions and Additional Information <br /> r, f5 }-re;�� e- ,t; bd;17.�)' - }<r-:�l�i,.I.* 'ii _t.i.1.f-{@Ae' -.:j1•''-'QIfE,!'a <br /> 14.GENERATOR'S CERTIFICATION:I eerlity the materials described above on this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste. <br /> Gerlemtor's?Offeror s Printed(Typed Name Signature <br /> Month Day Year <br /> �ay <br /> -1 15.Intemational ShipmentsImport to U.S. ❑Export from U.S. Port of entrylexit <br /> Transporter S ature fore its on Date leavingU,S.: <br /> k' W 16.Transporter Acknowledgment of Receipt of Materials `..' <br /> Month Ray Year <br /> 1 Printed(Typed Name Signature f <br /> TransporleJ <br /> f <br /> CL <br /> Month Day Year <br /> Z Transporter 2 Printed(Typed Name Signature <br /> E <br /> i M <br /> 17.piscxepancy <br /> 17a.Discrepancy Indication Space EJ <br /> Quantity ❑Type El Residue �Partial Rejection ❑Full Ae{ectlon <br /> Manifest Reference Number: <br /> 17b.Altemato Facility(or Generator) U.S.EPA ID Number <br /> 7 . <br /> U <br /> rat Facility's Phone: <br /> Month Day Year <br /> 17c.Signature of Akemato Facility(or Generator) <br /> WQ <br /> 18.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 17a <br /> Printedrryped Name Signature Month Day Year <br />_ , 169-BLC-0 6 10498 GENERATOR'S/SHIPPER'S INITIAL COPY <br />