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I , <br /> NON-HAZARDOUS 1 Generator's US EPA ID No y D,Manifesttr <br /> �r of 2 Page <br /> 1 9/8/2004 <br /> WASTE MANIFEST <br /> 38 atlytlWome and Mailing Address <br /> les <br /> P O BOX 903 <br /> BORREGO SPRINGS, CA 92004 <br /> 4 Generator's Phone( 888) 701-6600 <br /> 5 Transporter 1 Company Name 6 US EPA 1D Number A Transporter's Phone <br /> FILTER RECYCLING SVS, INC -NO I C A R 0 0 0 1 2 9 3 Q 4 (510)670-9901 <br /> 7r ns orter 2 Comp ny Name 8 U5 EPA ID Number B Transporter's Phone <br /> Filter Recyc�ing Services, Inc C A D 9 8 2 4 4 4 4 8 1 (909)873--4141 <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility's Phone <br /> Filter Recycling Services, Inc. <br /> 180 W. Monte Avenue {9Q9}421-2012 <br /> I Rialto, CA 92316 CAD98244448 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit <br /> No Type Quantity Wt Vol <br /> a NON HAZARDOUS WASTE SOLID <br /> P <br /> b Ag #&4411A4SUj&fi�l.,- 71 <br /> E <br /> N <br /> E <br /> R <br /> A c <br /> R RECYCLING SERVICES' DIAL TO FACILITY, EPA <br /> d #(LP D982444481 HAS THE APPROPRIATE , <br /> AND WILL ACCEPT THIS WASTE AS SHIPPED. <br /> ` D Additional Descriptions for Materials Lost e ove E Handling Codes for Wastes Listed Above <br /> 11A)SOIL <br /> I o/ <br /> t <br /> 15 Special Handling Instructions and Additional Information <br /> Wear appropriate protective clothing FLAME MINI MART (AGE) <br /> 1301 WEST KETTLEMAN LANE <br /> 24 Hour Emergency Response # (909) 721-2038 STOCKTON, CA. <br /> BILL SLABY SALES <br /> 16 GENERATOR'S CERTIFICATION I certify the materials described above on this manifest are not sublect to federal regulations for reporting proper disposal ai Hazardous Waste <br /> Printed/Typed Name Signature Year <br /> C - <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> A Pri d/Typed Na<e_1 Signature D ear <br /> N <br /> S <br /> p18 Transporter 2 Acknowledgement of Receipt of Materials <br />' R <br /> T Printed/Typed Name Signature Month Day Year <br /> E <br /> R <br /> 5 19 Discrepancy Indication Space <br /> I IF <br /> A <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> I } I <br /> T <br /> 4 y <br /> Printed/Typo Signature Month Day Year <br /> 4 <br /> .� ORIGINAL-RFTURN TO GENT-RA:TOR <br />