Laserfiche WebLink
Please print°or type.(Form deal ed for use on elte(12-pitch)typemfter.) Form Approved.OMB No.20%W39 i <br /> UNIFORM HAZARDOUS 1.Generator 10 Number 2.Page 1 of 3. cy Re Phone 4.Manifest Treckktg umber 1 <br /> WASTE MANIFEST C A L 0 0.0 3 6 6 211 1 800 42 -9300 O 8 2 3.3 7 5 8 JJ K <br /> 5.Generators Name and Malling Address <br /> Generators S8e (if t mailing address) <br /> FIRESTONE#028746 <br /> 720 E.HAMMER LANE <br /> STOCKTON 'CA 95210 <br /> Generator's Phone: 209951-2403 <br /> 8.Transporter 1 Company Name - U.S.EPA ID Number <br /> ASBURY ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7 T 2 Company Name U.S.EPA ID Number <br /> WORLDWIDE RECOVERY SYSTEM INC.' CAR 0 0 03.7 6 4 22. <br /> 8. Farcy Name and.Site Address U.S.EPA ID Number . <br /> YUMA YES LLC <br /> 2730 E YUM 13TH ST AZ 85365 <br /> AZ 000515-924 <br /> FacaLy's Phone: <br /> 9, 9b.U.S.D0T6escr"fvwWmqProperS WppkV Pte,Hard Class,ID Number, 10. 11.Tom 12.Unit 13.Waste Codes t <br /> lim and Packing Group 0 aM) No. Type ' Quantity Wt:Na <br /> 1'AEON-RCRA HAZ'ADOUS WASTE.SOLID(NON-CONFORMING FILTERS) <br /> DM <br /> 750 P. <br /> 3 <br /> �••_•�,• Ott t i <br /> adw <br /> ,. <br /> �Cf .:t#f6ir+3fREC 3- -4 $900 WQt�S Tf t Ml CERES OS: '*APPROPRIATE t• RSONAL PROW990VE <br /> RftSit COiTACT CWIttTRECb.424 9310* <br /> TRUtz PJFILE 161$ 8 X27 <br /> 1= <br /> 'a N itMrgttyd >hat�e. iiterds of ifda are fully W fly doacribed supe by ffia Pro <br /> ` tit mrd a re'kr�l [n W4r 1Xtnn fcrlran�poA aard(ng b. Wenatkp�mul t�rutatkms tf iia Pflny: } <br /> por6frtr81at8tetNs. , cordormfatltat�rrtsofgte. EPA.. ofCoriL. <br /> k 1 c8tyt( W. ltn3fied 40 GhR x@227(8}(H I am aletge petreralt oc @}(if!aimasmall is true. a <br /> 8 Dato leaft us.: <br /> f <br /> s 7 a amre Me t i <br /> t,w �� :. ya n r <br /> Al� 188 Discr6panCy`tndkation ! �Qum OType ®ResEdut Pard n L 6Fu8Roie&p <br /> I,v y 9• j :i' I <br /> SPA ID Number I <br /> ,, pp,^, 8tre of f or Day t ! <br /> kX <br /> . 19:F3J . Report '. . Codes,(Ge„rwdes for ha attlous Ee keatmmst and mqd ing <br /> 20. We Faa'6ty t7wner or.. of receipt of hazardous materials covered by ere maxdfest ezce{d'as rel in item 18a <br /> Pdnt®d(Fyp�Nares Maudlt Dap 4 _.` i <br /> EPA Formf)706-?2(Rev.3.05) Prevkwseclitimere.obsolete. DESIGNATED'FACII:IT1(�T6-DESTINATION.STATE OF REQ411AEt�) . <br />