Laserfiche WebLink
k <br /> ` k NO - AZAR ®US WASTE MANI ST <br /> Please print or type (Form designed for use on elite(12 pitch)typewriter) <br /> NON-HAZARDOUS EIG'.n.natoft US EPA ID No. Manifest 2.Page 1WASTE MANIFEST L 0 0 S 2 0 <br /> Document No. of <br /> d <br /> 3.Generator's Name and Mailing Address <br /> PMTIN-BROWER <br /> 4704 FITS CT <br /> 4.GeneratCA 9MIS <br /> o s Ph ne <br /> 5.Transporter <br /> t 1 Company Name 6. US EPA ID Number A.State Transportees 1D <br /> ASIB�+ Y4IENT'.AL SERVICES C A t0 a 8 2 T 7 a 3 6 B.Transporter Phone btV 97-1-4495 <br /> 7.Transporter 2 Company Name 8. Ts EPA ID Number C.State Transporter's ID <br /> D.Transporter 2 Phone <br /> 9.Design�a^ted FacilityyName and Site Address 10. US EPA ID Number E.State Facility's ID <br /> 10,940 AL.TAI T PASS ROAD 41 <br /> F.F cir 's Phone <br /> 11.WASTE DESCRIPTION 12. Containers 13. 14. <br /> Total Unit <br /> No. Type Quantity Wt.Nol. <br /> a. <br /> NONt,1NMDOUS WASTE LIQUID(WASHRACKJ CLARIFIER LIQUIDS) <br /> G b. 9 pC3 <br /> E <br /> N <br /> E <br /> R c- <br /> A <br /> T 6 <br /> O <br /> R d <br /> N , <br /> G.Additional Descriptions for Materials Listed Above H.Handling Codes for Wastes Listed Above <br /> N IIN <br /> 1 <br /> O <br /> Q <br /> N 15.Special <br /> Handling Instructions and Additional Information t�a�C f Yt^s�3.0 C <br /> •� USE 1�1'" GENCY'CONTACT: CHEMMEC 1-000424—M <br /> ® SITE, ;4704 11TE CT,r T0CKT0NAS, Ca <br /> Z <br /> AWAF� � AW AW <br /> 16.GENERATOR'S CERTIFICATION:I hereby certify that the contents of this shipment are fklly and accurately described and are in all respects <br /> in proper condition for transport.The matenals described on this manifest are not subject to federal hazardous waste regulations. <br /> Date <br /> Priinted/i'yped Name Signa Month Day Year <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials Date <br /> R <br /> A PHnted/Typed Name Signature <br /> Month Day Year <br /> 47 <br /> N �..... .::.t <br /> IS <br /> O IS.Transporter 2 Acknowledgement of Receipt of Materials DateA <br /> TPrinted(Typed Name Signature <br /> E Month Day Year <br /> R <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> 1 20.Facility Owner or Operator,Certification of receipt of the waste materials covered by this manifest,except as noted in item 19. <br /> L <br /> Date <br /> T Printedrryped Name Signature,, <br /> Y Month Day Year <br />