Laserfiche WebLink
m;rav a lhotecicon Aa <br /> QNB No.4050.0039(Eap 9-3096) See Instructions on bara 6. <br /> o.type. Fa.m desi noct lar v,r o t e (12, tt"b,wrye,, _�Pe8 Department of Task Submit«Ca <br /> Seraeeeem.California <br /> Genesatds US EPA ID No. M—ifen Documc n Ne. 2. Page 1 Infaimoliwt n M Aoded areas <br /> UNIFORM HAZARDOUS A L 0 0 0 1 1 5 0 8 9 1 3 0 6 aft <br /> WASTE MANIFEST "ro required M Federal law. <br /> 3. (enerator's Name and AlaTag Acidness�� r0 A. Sfax Merited Doam«n Number <br /> PRODUCTS CO AMI: NEAL DAVfiNpORT953 1306 <br /> n P,OeXp877� 9W0g DA'aENPORT CHFWICAL B. Sacro Garver ar's lD +"r" <br /> 00 r e Oita 910 ) 342-9<58 <br /> S. Traaporter 1 Company Name6. US EPA ID Number C. State Traapate/s ID <br /> DILLARD TRUCKING, 1,+Ce , D. Traaparler,Phax (60D) 675-1066 <br /> J <br /> Q 7. Transporter 2 Company Name 8. US EPA ID Number <br /> V E. State Trompot er's ID <br /> O d I g12. C�wm <br /> porter's Phone <br /> Z 9. Designated Facility Nome and Six Address 10. US EPA ID NumberFacility's ID <br /> r) O '.LAICAL VIASTE 11ANAGa4EtET ' <br /> 35251 OLD 00/60b/I <br /> S KY.t.ItIE RCAp ry's Phone <br /> j V KET:-LEM U CITY, CA 93239 (20)) 386-9711 <br /> Z 11. US DOT Description(including Proper Shipping Name,Hayord pass,and ID Numb«) 13. Total 14. U Quantity WI/Vel L Waste M!mber <br /> ~ ° p �pT,[�p1 tIyDgp��RBOC7 C00.`Tp�.IIiATED SOIL) 9152,611 <br /> 3 l ON LiC12A tiA:'ulRDOUS NASTi: SOLID <br /> o f 0 0 1 D M 0 0 0 Y E1VfbWMCRA <br /> op N b. Seeks E S <br /> y R <br /> A EPA/Other <br /> co T c. r <br /> 0 Sar <br /> R EPA/Other <br /> Z d. <br /> W Store <br /> V <br /> h EPA/Other <br /> Z <br /> J. Additional Dexri <br /> Q ptiom for Materials listed Above K. Handling Cod"for Wastes listed Abe. <br /> 0.0. 11A) PROFILE GAJ 1423 ERG# 171 a. b. <br /> J <br /> C. d. <br /> Z <br /> O 15. nie Handling Wtrystions and AddiBonaI Int alion <br /> a le Y P.P.E. (i.ee, rub r rgLwes, ru!;:rr s.;wt3, 24—I:our Lr^.err;or:cy Telctp::onc!'?: <br /> Z Oro ec:.ive clothing, r,,�lirator, o+x;len, e :c. ) <br /> W 'ITE . ARC,% a'.�441.3 <br /> = 205 eJOT TI, Ci';IT. .. STRI:1 . r <br /> - voa�Axxi, _n JJ3 ' 1G(:7-11J Oi?-3(.2;:2 <br /> -s 16. GENERATOR'S CERTIFICATION: 1 hereby declare that the conteids of this consignment are fully and accurately described obow by proper shipping name and are classified, <br /> Q packed,marked,and labeled,and are in all res in condition for transport b hi h accord' x applicable iaernotionol and national g <br /> V Pitch properY highway uq PP government regulations. <br /> J IfI am o large quaatny generator. I cern <br /> NJ fry that I how a program in d of a mens,reducthe .lame and al Curr of wane generated to the degree I how determined and future be <br /> economically practicable and that 1 haw xkcxd the pracficable method of heatment,storage,or disposal currently avoilobl<x me which minimizes the present and IvNre <br /> threat to human health and the enviromnant; OR, 8 I am a small quantity generator, 1 haw made a good faith effort N minimize my waste generation and select the best <br /> of waste mono ement method that is aroilable to me and that I Co.afford. ! <br /> O Primed/Typed Nome Signature 0 i l Mornlh Day Year <br /> Z T Transporter 1 Acknowledgement wbd tf R <br /> emenoecei t of Materials <br /> W R <br /> O A Prkted/Typed Nome Sig aNre <br /> W N i /. Mo .Day Year <br /> W � 7.G �/l'</ i! J.i✓' rat, 'L'i ', <br /> tFss l 18. Turns n«2 Acknowle ement of Receipt of Materials <br /> Q.O F Printed/Typed Name Signature Month Day Year <br /> R <br /> QI9. Discreponry Indication Space <br /> U F <br /> A <br /> Z C <br /> I <br /> L <br /> 1 20. FacilityOwner or Oo,wwor Certifkatian of recti 1 of hazardous materials cowered b this manifest..mPt as noted in hem 19. <br /> T Printed/Typed Nome Si retire <br /> IT - 0 Month Day Year <br /> , 1 <br /> DO NOT WRITE BELOW THIS LINE. <br /> DISC 800-24(9/94) <br /> EPA 8700— Green: TRANSPORTER RETAINS <br />