Laserfiche WebLink
Please ptlntar ! � - p Foam Ap vea.OM6 No.2050-(ID39 <br /> UNIFORM NA2AR000S L Genenbr IDN er 2.Pepe t of 3.Emepency Reapmm PM1one Manifest Tq'ape ryg'um�y oo �w3 <br /> WASTE MANIFEST C:a):flt'n.t:'?P"'" 1 1i5.31t-'�.':.:' L3.�i 1 ..9 C:3Y� JJK <br /> s.Ganwebla Nam.ane Ma111n9 AearoaeM�' �(�G: fR. vE el.:.k'-f.- Can2F'f3er��asua Aaereaa ofamereMlnan manna aaaress) <br /> silt w:w.IAL�ffR•3LiTON S'f. <br /> 31'OI11TC3n1,C:: Sifi'Sf3 <br /> GenelxbYB Pnon <br /> B.Tmportert Company�Name m V.S.EPA ID Number <br /> `:��h10S F_NP✓IPdUNMEntfgl. S2RV(CES iM1IL:. VA.004 F-£. <br /> ].Tanporto2 Company Name U.S EPA ID Numbw <br /> B.oeagneletl Fedllb Name ana SIIe Aaeaean R>Mdcv ENViRIJNF3ENTAL SrER VICC:S btiC: U.9.EPA ID Number <br /> YStS SOS{R1 RIVER Rf1 CALY]SaL{LR5 <br /> UJE�Sf 9AGRAMENrtO,CA 95691 <br /> Facll 'a Pnone:53o-L!1-E?9:' <br /> 9e. ah.US.DOT De&aiptlan Ond WNg Pmper 8Nppkg Neme.HSTAM CIvu.lO Nuaieq rD.Oonralnen ti Tdd t2.Unh t9.Weare Coaea <br /> RM aM pcklnp(ianup(Ifalry)) No. Type Ouently N'INaI. <br /> t NON RCR.4 HA�OGU9 WASTE SOLO (UIi.,OE9RI5) A• �' P 'i$a <br /> 2W 2. <br /> 3. <br /> 4. <br /> O.Spedel Xa 1 rg ruVudbne erq Onel lnfomatlm <br /> 9Dt PRGF31lEg ERGisi�rr 72'ES�dl4 — J I � <br /> F1sVVALERS TO F3E TR.WNF_D a1ND rJe.E APPROVED PPE �� ������"5�-5— <br /> E.R CONTRhGTpR[ R.V3..fOS ENVIftUNAIEMAhI SER'✓tGES � ��S— <br /> t5. OENEMTOR'S/OFFEROR'S CERTIFICATION: Inenby sedan NM Ne mMmleMNle wwlgnmenl ma(ully ana ecwobly aeacrmatl e0ova by ala propel aM1lppig names ertl are rJmalllea.pwFagetl. <br /> mvkea ma IaOehE/plecaNea,eM are In all raspec4ln prover Cwaltlw br 4anwort BccoNing\o appllrahb Inbmatlwdbhtl rellonal gwemmenlel raguletlwa.If eawa anipnienl ma I am Ins PAmery <br /> ' ByoXer.IcvrlNy alai gle wnbnb ci Wa WnalBnmenl wnrormbtlre lamm ollM atlaMea EPA Pcknowlaagment of�a!M1aen /-`� <br /> '' IceMly Intl Me waele mlMmlvaon alalamant Mena(lea ln<O CFR 262T(e)(Iflemalerge quantib 9anerelor)oC(ht(iflvmeamell quantiy qe br)ds ime. <br /> OeneMala/OR la Panlae/lypea Na eW y'� J 0.bnln OeY Year <br /> ta.IMem.uwa� nbma^u �Impuabus. �E@annomu ' Pan aren3'yroxic <br /> �_ rremwaer algn.bro Da expwra onM: Dau laavug us.: <br /> t>.Tr.napaMr AG[nowlatlpmanldRewlplMMalende -' �:.�.: <br /> Tenaponer t Prinb YP�atl Name / Slpnarwe-.. ^ -` i �" MonIM1 OaY Yev,� <br /> w Tranaportx 3 PMIeaRypa Nam Slgnv re - � MonIM1 Oey Y <br /> .a. ,S.Dleal.panq �- . <br /> tBe.Dlacrepan[y IMlwilon Space O Oumllb �Typa 0 Rvltlw Q PWaI Retacllon Q FUX Rejectlon <br /> Menlfeat Ralefenca NumOec <br /> t80.Al1emeN FedlXy(or Oenenaltt) V.S.EPA ID WmLar <br /> W FwNiy'a Pnone: <br /> 6w 33c. 9nebn MAllemab acilly(or Genereiw Monty Y Year <br /> yt9.Hazaraaua Waeb Report MvnegemeM Me1nM Coana 9s.,cWeff ror naaaMaue waele beeMenl,alawael,eM recyGing ayNama) <br /> o L 2. 3. 4. <br /> zo.Oealgnelea FasRb Dwner or Dpervlor:ceMbtlon orrecelptor travNwe nvbllais wwaaa ey ale maNlB9I exwpl m nage In nem fSv <br /> PrIM YPe 9^elula �.� MwN Y <br /> ��/ Gi( �% � Tf <br /> EPA Farm RyaD-22(RaY. 2-t>) PreMpua eatuame ora absole3e. DESIGNATED FACILITY COPY <br /> .�....•.m �co.cm:um nva uavccT vmI unwc RFRPnNSIRu rt3PR HNDFR THE aMANIFEST ACT.SEE INSTRUCTIONS ON REVERSE SIDE. <br />