Laserfiche WebLink
Ateaso pgnl hrt3 . ggtl& qn.W.for use on efite;(t2.pR,e l typelvdfer. Form{tp K V d.OMB No,20500039 <br /> 13NIFORM HAZARDOUS 1.GonetatorlD Number Page t of 3.Emeg7ancy response Phone 4.RMarttfas"'792318 <br /> TracId Numrb�er <br /> WASTE MANIFEST C A(.0 O(?2 69375 a.. (500)4'2}-910U 79 2 3 1 8 JJK <br /> 5.Generators Name attU, tgtlddm v ft!�orafet s Site Address(If different than matt ng n+&(rasa) <br /> PICK N PULL <br /> 3927 CLARK llIR, <br /> VOCRTON CA <br /> ttnn aaW-aPhone; 209 402-1927 <br /> trs Ttaitspgrlttr 1 C�1rSpitti�'t�giil,G U;S,GPAd¢NurtStloP <br /> ASBUO Ef�VIRI ONMENTAL SERViCES GAUD 2 8?"t 7 rJ 3 6 <br /> a saitspptl 4Company•Name U. .tit3yifj'Nttmbgr <br /> 8;Designated Facility llama and Site Address U.S,EPA ID Nuntbar <br /> ASSURY LNVIRONMENTAL BGRVICE-CERES <br /> 1920 MORGAN RD, <br /> CORES CA 95358 <br /> F..acI 'a Phone: ;?p - q26 C A L O O.O 3 9 3 6 3 0 <br /> 9a, 9b.US.DOT Description ilncfudng Proper Shipping Name,Hazard(,Aase,10 Number, 10,Containers <br /> FtPA and Packing Group{irony)) No, N.Total 12,(Inti 13.'Nasta Colas <br /> Typo Quantity ivol, <br /> ' 'NON-RCRA NAZARDONS'V'UA5TE,LIQUID(USED OIL/MIXEtb Olt.) <br /> 22:L..,„ <br /> 0 01 TT 0' G { 3 <br /> LU i <br /> 1; Spacial Nandiing InslrueUdns and d titfona tNSorma on ! <br /> FMkRGCNOY CONTACT:CHEMTREC 1-804.424-9300 WOES.TERMINAL:CERES G' "APPROPRiATE PERSONAL PROTECTIVE' <br /> CQUIPMENT*EMERGENCY CONTACT CHEMTREC 8OO.424-9300 k TRUCK# �. <br /> tb. G6NERATOR'SJOFFEROR SCERTIFICATiQN;thereby declare that tha contehTs of Utis censignmeni are fully a!td accurately described above by She proper ahlpping name,and are class!i K packaged, <br /> marked and.labeled/pklaardad and era in alltespecls in proper send tbn for Transport according to applicable intemationaS ainaQonat govammantal ragulaEtons,If export shipment and lam the Primary <br /> Id <br /> Eitporter,I certify that the.contents of this conaignmonf conform to the terms of the attached EPAAoknowlodgmant at Consent <br /> I cedify that the waste minimization statement idenllfied in 40 CFR 262.27(x)Of t am a large quantity generato4 or(b)Oft am a amafluanti <br /> Gennratpt'sfOfrs er Pnittrtb7yodi rSl q fY9eneralor)feUsta. <br /> S!gnnturo Oxy aur• , <br /> ~ © �'f ✓ <br /> ,i .lntemational Shipments <br /> t S Import to U.S. E S, <br /> Export from U, Port of entry/exit <br /> 7lartsporter signature(for expotls only): •_ <br /> l7.TransparterAoknovd p Date leaving U.S.;. ,.. <br /> � edgrnaM of Recef t of tviatadals <br /> T. rArtei top ski Sf?Vt)iYta. <br /> Sigr nth'it IV <br /> f3a <br /> Q runs'orter 2 PrintadlCyped arae ' �✓ a (� �,�` <br /> q ' 86naiure <br /> r Month Day Year <br /> 18,Discrepancy V <br /> 18a.Discrepancy indication Spacre l �f <br /> t !Quahtily E!_t type. D Reeldue <br /> LS Partial Rejection ❑Full Rejection <br /> 14b.Alternate Facility(or Generator) tAanifest Refare ce Humber; <br /> 7-r U.S.EPA iD Number <br /> to <br /> LL Facillys Phone; <br /> 1 <br /> ""i <br /> Month Day Yaar <br /> 1gHazardous Waste Report Mmiegament,Ateewd Codes( odes fur hazattiuus waste Uuatmunt,dispOsol,and rasyGf ng systems) <br /> 1.. 2, <br /> �4 4. <br /> 2t1:Designated Faaity Owner oroperator:CerQ6catien of receipt of hazardous materials covered by the maNlest except as noted In Item lea ; <br /> 1'r±ntodiFj'pad'Nt<rtia <br /> ,.Y. $pn�itrtt Far h 'oay year <br /> �Rev.3.05) Previotis'edlUDns are obsolete, r y: <br /> >iGNFyl7'Et?t Ar,'I!ITYTO 0ES4TIP.'T10N STAT.ta(IF 1 EQUtRr.C�} <br />