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Form Approved.OMB No.2050-0039 <br /> Please print or type (Form designed for use on elite(12-pitch)typewriter.) Response Phone 4.Manl}sst T QC �( <br /> 2 Page 7 of 3 Emergency p (�o C 8 V CI n <br /> UNIFORM HAZARDOUS <br /> 7.Generator 10 Number 0 j c` <br /> WASTE MA Generators Site Address(if different than mailing address) <br /> 5 Generators Name and MaaingAddres> <br /> U S.EPA ID Number <br /> Generators Phone I <br /> 6.Transporter 1 Company Name <br /> U.S.EPA ID Nurr:ber <br /> 7.Transporter 2 Company Name <br /> U.S EPA ID Number <br /> 8.Designated Facdity Name and Sde Address LL_r t r r ;..1 c S. . <br /> 83TH STREET <br /> SACRAMENTO <br />