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4 � <br /> NON-HAZARDOUS 1. Generators US EPA ID No. Manifest 2. Page 1 } <br /> WASTE MANIFEST Document No. <br /> 5 °f <br /> 978 1 6142004 <br /> _ 3. Generator's Name and Mailing Address <br /> Slaby Sales x <br /> P.0 BOX 903 <br /> NReREGO Atl 20 88 D04 <br /> .,.:t <br /> 5. Transporter 1 Company Name 6. US EPA IDNumberA. Transporter's Phone T <br /> FILTER RECYCLING SVS, INC.-NO C A R 0 0 0 1 2 9 3 0 510 670-9901 <br /> 7. Transporter <br /> 2 Company Name 8. US EPA ID Number B. Transporters Phonexss1 <br /> n.� <br /> Filter Recycling Services, Inc. CAD 4 8 2 4 4 4 4. $ (909)873-4141 n <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number C. Facility'sPhone <br /> 1 <br /> Filter Recycling Services, Inc. �y <br /> 180 W. Monte Avenue (909)421-2012 <br /> Rialto, CA 92316 C A D 9 8 2 4 4 4 4. 8 <br /> 11. Waste Shipping Name and Description 12: Containers 13. 14. _ <br /> Total Unit <br /> No. Type. Quantity Wt Vol <br /> a N - - <br /> . <br /> c b. NON HAZARDOUS WASTE SOLID <br /> E <br /> E D P <br /> R <br /> A c. <br /> TFILTER RECYCLING SERVICES' RIALTO FACILITY, EPA <br /> 0 <br /> R #CA10982444481 HAS THE APPROPRIATE PERMIT(S) FOR, <br /> d. AND WILL ACCEPT I h AS . <br /> r <br /> m <br /> D. Additional Descriptions for Materials Listed Above E. Handling Codes for Wastes Listed Above N <br /> si. 11B SOIL ztt .- 3 C t G 2-C-- I y`Q1 <br /> 15. Special Handling Instructions and Additional Information <br /> Wear appropriatelprotective clothing QUICK IN SAVE(ADVANCED GEO) " <br /> 7200 S. EL DORANDO ST. <br /> 24, Hour Emergency Response # (909) 721-2038 STOCKTON, CA. 95206 <br /> r �ti <br /> BILL SLABY SALES <br /> I <br /> 16.GENERATOR'S CERTIFICATION: I certify the materials described be,, an this manifest are not subject to federal regulations for reporting proper dispasol of Hozardaos Waste. ' <br /> Pr' ted Typed Name L Si n ur Man Day Year E <br /> 1 <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> A Print /T ped a e Signature yor e' <br /> N <br /> S <br /> p18.Transporter 2 Acknowledgem nt of Receipt of Materials 1 <br /> R 1 <br /> EPrinted/Typed Name ,Signature Month Day yem r <br /> R 6 ` <br /> { 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L20.Facility Owner or Operator'.Certification of receipt of waste materials covered by this manifest except as noted in Item 19. <br /> T <br /> v <br /> Printed/Type p Signature _ hlanth Day Year <br /> e� S ptill I` <br /> C;. AL-RETURN TO GEMER ATOR <br />