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nuc-12-2409 tx:;AMA 514-M-0tiNjp F.OM55 F-15T <br /> Farm Approved.ON1BNo,2050-0039 <br /> t'Ieasa paint or type. Form deafgnQd for uee an e!'de 52 itch)ty 1er.) <br /> R OU_5 t•Generator ID Numear 2.Pa�aaa 10< 3.>:mer@e Roap❑rtse Phone 1.Man ct TrdcktngNumber <br /> UNIFORM kA A _. - T 1 Ot��r4 4-93{30 002587198 JA <br /> WASTL MANIFEST <br /> 5,aenemlor a and MallIpgAddras <br /> Geneml❑rs sea Addrett3{If tlHferant than malung address) <br /> 4 e#/ c4.re- Dig pne'li; r. <br /> /f 7 P. 07 oto-' p " <br /> $%o'K IT ' &0 ?,Y"x d 7 <br /> Genaral4Ye Phone; '�_o U.S.EPA 11)Number <br /> fi Imnsportar 1Cam�yNerlle CAD982413262 <br /> EVE (GREEN ENVIRONMENTAL.SERVICES <br /> LLS.EPA Ip Number <br /> 7,Tmnapade!2 Oampbny Nnrpa <br /> U_5.EPA 0Numbt3r <br /> 9.oeslgnared � <br /> 6880 SM11-1-1 AVENUE CADa80887418 <br /> NEWARK CA 9456U <br /> Facill N Ptwna: <br /> Bb.U.S.DOTU❑-,uipdon(indud9ng Proper Shlpping Name,Hazard Qaes,rD Number, 1e.Con"alnmrs t1.Tora1 Fj7_Un1,1 1S.Wade Coder <br /> Do. fduentih� <br /> NM and pewng Group(1t any)) No. Type <br /> 0 ON�RCRA HAZARDOUS WASTE, LIQUID I TT <br /> w <br /> a, <br /> 4. <br /> 14,Special No olln Inswr.IlansanimuldnnalInf❑mwllon t} (NvOlCE # <br /> DOT ERQ9171 WEAn PROTECTIVE CLOTHING SALE► ORDER 0 <br /> 1G, p�N�MTPfi'afP.FF HR'S rERTIFICATIQN: I hereby dedote that to cantapit pf Ihls cansigl mast are fully and accurately deacrtbad ribove by Vte proper etuppino Soma,"are daaaUlad,pmckapAd, <br /> malhad and 1a¢elagplamiMad,and ere In all raspacts In proper wndlUan for tronaport according to appllcable lntematlonal end natlonal govemmantal IagulA9tons.if oxpart shlpmant arra I An Na Prfmary <br /> Dportar,I cartify that the wnw1a of thea oohslgnment cunf❑fm In the Io ns of Ile atlachad EPAAeknw,ledgmenl❑f Conront <br /> I cartffy 0 1 Lha wjelAp[NmlmUgn statement Idendfiad in 40 CFR 2f+2,27(a)Of I em a larva quonpV gimnill or(h)(a I am a small quantity gaaerata)is true. <br /> Gentirawr'slplrero gladrrypod Na IQO ro Month Ray YearT' <br /> 1B. nta,na oval sh amenia [ lmponln u,s. D Fxpc f"'.U.S. Pod a,enlryiexlt <br /> Traneporior ulonalure(fur SIMM only): Crete leaving DR: <br /> i7•Transporter Admowledgmenl of Rucelpl of Maladele <br /> ranspd r Prints oma gndture Month Cay Year <br /> i <br /> TrenSpoder P nredrTypad Nemo <br /> Signature Month Day Yaer <br /> 18.Discrepancy ��-----qq <br /> 1Ba.pls�apanty Indication 5paca quantlty, D Type Rosldue L 1 Partial Ra asltan ❑Full lieJed3on <br /> hlantfast Ralerante Number. <br /> 18b.Allema9e Fadl'ily{Ar U.S.EPA Ip Number <br /> GunuralbT) <br /> C� <br /> FadllglsPhage- <br /> tec.SlgnaturnorNtomalefaclllty(❑rGnnarotarJ Month Say Year <br /> In (stns..- ---------- <br /> _.�;)�;Hamrda��-W�ta Ftua9efna�a4tts��A4d�(i;e�[1ea:SsuttaLtitdausweet�traaknautwltlspasal�rzd G� 1—..�:,^---�.._..-�- — --- . <br /> W. 3_ 4. <br /> 20.Owlpnalvd Facility Owner or Operala.CorgpCjgpn of moolpt of pazardous mal❑rWri cuvered by tho mnnlfval-mpt as nd❑d IA Ma ay car <br /> nted,Typo oma / Sq emre <br /> 7J V <br /> EPA Form 8700.22(Rau-MG) Pravl❑us edlUo 3 ere dhsolate, !�� b NATEd�ACILI E7 I]�S ON STATE (IF REQ111REp <br />