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1L750 F'er3e:EDl IFt;jsttfr f Vo!, rA No. 30 1 TueaE:dy, Fe`'rjan/ ^n. ^093 I Nullcea <br /> cs,a.•.wescr:nc-�.vm»swr,��.:a ,;c,r.-s:.,..e® _asY.wnwx^..w.wx:,•.acm�cvn..+r,onwYs�asxa•� <br /> GSA tis. /1343-YA <br /> P . r Ito. - N. ELITE •ro. '// '+•,..rer.•In,w, ,.•s. •SR N4 Iry ulr. Jii,, A;T..owJ OtlN N,, ISc-% '/,1S <br /> U.S. ENyIAONNENTwt ...-ECTIOP AG;.ACr 'LV$1RIJC J"L : IS yU,u fd...aii a peynnt— <br /> >GT5_p d•/d NOTIFICATION OF HAZARDOUS WASTE ACTIVITY eo label. 61149 At sn the space at Belt. R any <br /> of the inlormaUOn can Lhe laud is mconect, <br /> :Ns*•LI-w Tlo,.'s ' draw a line Eniouah it and wooly the correct <br /> ER• : NO. Information in Inc appropriate section he: <br /> r <br /> low. If the label is complete and correct, <br /> ;^.wE..o__.TIDA IEeve Items 1, 11, and RI Wow blank. 11 you <br /> did not refllw a praprinted laual, complete <br /> INSTALLATION all items. "Installation" means It single site <br /> d_ .ecu s PLEASE PLACE LABEL IN 7VZ SPACE where hazardous waste Is generated, treated, <br /> stored and/Dr disposed of, Or a transporter's <br /> IXlncipel plain of business. Flew rater to the <br /> INSTRUCTIONS FOR FILING NOTIFICA- <br /> dt LOCATION or TION before completing this form. The in- <br /> formation requested herein is required by law <br /> /Section 3010 Of the Resource Conservalion <br /> and Rrrovrry Ac!1 <br /> FOR OFFICIAL 111E ONLY_;_ <br /> COUNEN T3 <br /> f <br /> ,NSTALLAT,ON L O. 41M5ER APPROVED r• C 'JFO -- <br /> e. <br /> AUG 1330 <br /> 1. NAME OF 14157 ALLATION —`�'� '' �`� <br /> rrr'Nan++n�.�..::. ••_ +Yrlist.+Y•�f4'�^re`s�°'•' <br /> C1 <br /> A S C P IS PRIE E!L S A� <br /> S1dC� P) IDIJj 1FI-121 1I <br /> 11 IN ST ALL eT10N MAILING ADDRESS _�-�` <br /> r .STREET OR P..i BLe <br /> 3 812111d7l <br /> I,r <br /> C.TY OR TO.N j ST. J 7 <br /> c <br /> 4 4 A N <br /> l <br /> E 11L LOC ATI Or+ OF <br /> r _ STRECI4OR AOVTt M YRER <br /> x101S I TIE P � El,I m�j <br /> CIrT OR TONN Sl. jIP CDL[ <br /> 6 ANTECA CA95336 <br /> 4V. i.ISTALLATI ON CONTAC 7t� <br /> NAME -iI,1 "I L( 11.11, hill, A 1.1 I PCNL w.J.�w. •R ro I <br /> TBOYDELd ALBER1T� FrC Q Y MANACEP.I !n 9i:S.2. 3 "c3I1� 21, <br /> — -- <br /> __._ <br /> V. OWNERSHIP <br /> A NAME Or NSIALLATION'S^LEGAL OWNER'R"�••�__.—�_ - • <br /> vi TAP CORPOP . I <br /> .! npr Of peN[nlNronnu, rn.aPP•ePNar./attar thin se., VI. TYPE OF HAZARDOUS WASTE •CTI'vrT" <br /> 1, !l�'A. GLN(RaTIGN U�9. TRANSPORTATION If m.Ht. ,uw 1"�, <br /> F - FEDERAL NTNON•F EDi RAL 12 <br /> t.Y-1C TRI AT'SIFC'D'4PnSY a'J i-�T VN.^.CRnPO'.NC IM I(C"ON <br /> 191. NODE OF TRANSPORTATION rrwmporte rA only, _'_ _..a. - <br /> ijA AIR C 9. RAI C. HIONRAr LID •ITER CIE OT 4ER Hp !r1 <br /> t aY •A a +-..el!' <br /> Vlll. FIRST OR SUESEOUENT NOTIFICATION761 <br /> Mara •X' in the upPropnste Loa to indicate Whalher this Is your-u4.Otlalmn'a first w:Ibut:on of hazardous Nene activity ur a autIser+ent <br /> nubOuuun. 11 this is not Your first notdaat4on, enter your metallstmn's LPA I.D. number w the space provided LeloW. <br /> O IMST LLLAST aLIw\1 N <br /> C�qp A. FIRST ROTIFICATION e. SU aS[DU ENT ND71nCaT10N pew,loa Ind p <br /> I'_ -117 TION Of HAiAnMOUS aA5 L _ . <br /> to - i3a•L: - — _ °•s. `�"�_�..� <br /> pl Ie to m ""Ithisn lne rce o/this loaand prnv.de tis.- re Quested Inlurmn•un. <br /> EPA FI:a10700.12 t2-Jei CD;i TIHUE JN AE`uiE <br />