Laserfiche WebLink
a- <br /> nt or type2ffzorm W un on tYt• 12 Form .OMB No.2050.0039 <br /> UNWORNW"TE ',a.n.raera��at,bar2.Pop'� a b" 008689911 JJK <br /> 6. Haer rd Ad*m CwwwWsSAaAddrmRdftwl tw mdktp od M) <br /> m 9 <br /> a15M N.Tharlon Rd. <br /> °°°° n+attV"'y Loa.CA 95M <br /> Ek Ori*^CA 95024 <br /> Gonwabra Phar: <br /> 6. rano M*1 Nmw U.S.EPA I %umbar <br /> Franaotdw ErMrawnwtal SwMow Im. CM000171017 <br /> 7 Transporter 2 cam"Name <br /> US EAS ID Humbw <br /> ENV B M+arwmltlal IrltwnadmM CARO001 <br /> 8.Desig-lad Fack Nrtr and Sia Aft= U S.EPA b Ntntbar <br /> • U8 NVrA3Ml00m <br /> Miry•61 3 of 1 e aw" <br /> Dewy,Nv Min <br /> FKWsPrarw 775463�=. <br /> ga, 9b.U.S.DOT Desa"m(xkft Pmpor 3tripoM Hann,iW= Cba,10 Nunbw, 10.cafthNs 11.lbw 19.UNI 13.VM*Codft <br /> HM and Padortg Group(1 eny)) No. Typo OtwliAm WL/Vd. <br /> i NON•RCltA F1nmdwm Wasta,Said(Oiy Cart n*M ed Dt1I t ftM , M. -�$ +� 223 <br /> ��FNAY 11 2016 t' <br /> 14.SpKW HNKWV lr,* aw and Addtiawlmbmufjon <br /> MIm dw To Be 40 FM TmWosd And Use Pm w PPE <br /> 9 .- <br /> 961) (Ohm Dmbrb)ERO tM171 <br /> 15. GENERATMV0FFERMS CERTIFICATION:I hereby dKLw lhm Br anent of to Ira A/y and "dswibod above by rhe proper stgpbq nam»,arm are rleavNad,padc29W, <br /> marked and Iobolel0 carded,and ars In al msp"in pmW co dMm for Uwmpod acmdrg b*0cedo klwre8 M N%d rribnal gorwr w'W mgda8orn.If azpw gpmem aro I Am tw Primary <br /> Exporter,I ow*tri ew a Wft of this mnsiprvnrA orlam b the Wm of Cr atmdwd EPAA&M%dansrd of Cm"N. <br /> I owtiy twl to wows mninamlion stk*r*M idarl fled n 40 CFR 26227(s)(it I am a WW qjw*gerrrabj or M(H I am 3 small gAnFAy gmwalor)Is hue. <br /> C rmrMe%l0&%W%PrlftC Morin Year <br /> 4L I <br /> 0 1� <br /> •r 1 tetrwtonY ❑ExDort Gam U.S. d erNyledt <br /> � k0m-u&'Y=tt_. <br /> = Trarrporta �( a+h): Dam fr wg U.S.: <br /> 17.Trr xft Adamowbdp wo of Rao*d aMb UM <br /> TranWartx 1 PrhtaNTyped Name S+9)7 Moo7 Day Yew <br /> tIVV`lAlo* Day ` <br /> �MCI Year <br /> I&oba varicy <br /> I ac Dktaapancy Mdcdm Space ❑ Quonay ❑Type ❑Readua ❑Parlial R*db. ❑Ful It)ad. <br /> lab.A)rnwb Fealty(a GaiwlW U.S.EPA 0 Number <br /> V <br /> Faaily's Phew: <br /> 16c, ahso of Ai iw_r ad ity n CWNSW ear <br /> y <br /> 1g.Haznduue VYasb Rabat mmoporrMN MWiod Codes Q.a»codes br harder waste lis w dspoaai,and,0408 syd—) <br /> tar 1 Iy�j(� F. <br /> 3. 4. <br /> 20.Daaig~F or OWAor Cor0lieslon d rwW of harardow maMriW o"W by the ffw&sl n Nom 18a <br /> PM&GWTY*7 Orear <br /> vdtc .. __- I- ..-- 11A <br /> z <br /> EPA Form 8700-22(Rev -M P edt"t'orla are DESIGNATED FACILITY M DESTINATION STATE(IF REQUIRED) <br />