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Ptrtase M or orm nad toi use ar egte 12-pft).typ9mi6j'.)" Form Approved,OMS'No.2054x39 <br /> UNIF.ORkt HAZJaRtl0U8 '1.cleneretw IDN 125POO'.1 of 3.Emarwg aeapana Phone 4 Melt- <br /> wasrA9Ar�� sr GAt.Cltfd34557 37 '' 4f� 7z L <br /> Less era a Bits Address(d titian mdFr� <br /> aRa&Syr."Cl'Cu, o ,A11T,.:• Menta <br /> r <br /> '32M 0;0 Da#dci St. <br /> glo"al CA 0* <br /> ftw6ws Phone. . <br /> e U,S.EPA NO Nurser <br /> Trana�io tN 2 CvmParry Narna U.S.EPA ID Number <br /> 8. FeCpNy iwld NiAt�s ,y U.S,EPAer'V Numb <br /> ECE).+`8Ak+d+3Ytt1 a�'( 2{!f <br /> AM wmw <br /> y( <br /> Ent-carbMUT$462f>USA <br /> Fat�ify✓s Ptsdte. <br /> ga f,U.S.DOT (in "frog Proper Ship N Naas,Haiard Cis,K)Nw,iber, lo..qgn 11.Total . 12.Urdt <br /> 13:Wasta.Codas, <br /> HM �d? 9�atPfdY1) No., Too Quantty NRIYoh' <br /> Nort <br /> 3: . <br /> C. 4.,. . <br /> 14: rp and i <br /> iN RBl r7 • FmcYel tiAlLCs#R 1yiJ:" , . } i <br /> i3osha#;##�l• bt - � <br /> :. .hw iot38 <br /> 1@,.GENFBATOR°8(OPgEROR 8.CERTIFICATtON I hey dectaro that ttre ooniants ot#dde conslpnmanlyra fuWjr ped maairatdy dasatl�d alw�s by tl»proper etdp n4 rtdtro;and ero deed <br /> o�.� and eroUs ey respects h Qtnper w fa fran>rsart acasdinp m app> abie and sm6arcat gcmmer�d repu�tions.itesgrot{ah'pniertt a6d 1 t+in the PAhsery <br /> Fxpgrserl.l oa15y t the Ct istenb of mns4pnmant Co+stomi ioths kris ottho abdr,id EPA►duwyledgm:'st of Gorecois6. <br /> IemfYy)o;at(tto.vr fps NWAh ent ldanff h 40 CFR 262 27(e)(d I drri a,kiga Qsiahtity.gtrwraio�or(b){if i am d anaA'auentity patatetx}b hiss,. <br /> �. yAn '; <br /> , 1 .t' <br /> 1t3:hsbanatioisd aMs . <br /> .•'alm{wittoUs, C E.Wko <br /> rot1, Pei of <br /> .T far <br /> it.i A nwAadgmantofRaetgt fmm <br /> 1 > ear <br /> E <br /> ?' <br /> I � , <br /> R f 6a t J Quantltp Type ❑Residua Pm#al Rejedbn L_J M Rel�doti . <br /> MerdkalROWOMNumbar ' <br /> tab. F {a tsansrskor} U.S.EPID Nuw4sar ' <br /> a <br /> v <br /> F s Phase: <br /> 1 of Fadifty(or p nerator) rAasth pey Year <br /> 19.Hkgfdous Wp ,Rqm Managanard Methw Codes Q,e„eodea f4harosdods waste haatma t chposal,and recyc�ng systems) <br /> 3 4` .. <br /> �r � ,rOs-w-��'�otr Opareia:Caitiftcatiwc of ia�pt of twzardous r,�teda£s ccverad by the madtast extioiit as rwt�!h Item 19a. <br /> • �C..%CJ ipnaasre� on Day:' f <br /> EPA Form, Za(Reu 346)Previous editions are obiolsta: r AESiGAAD,FACImY.S GOf'Y <br />