Laserfiche WebLink
SSS SK SHIP* 228634378 <br /> Please pmt or type. O G 6 9 6 d 2 2 3 $ K 5 <br /> t.GeIerater lD Number Frim ADMved.OMB No 2D50-0039 <br /> UNIFORM HAZARDOUS 2. ago 1 d 3 E Rto- <br /> 5. <br /> s se Pt one 4.Manffest Tracking Number <br /> WASTE MANIFEST CALOOOM6793 1"!W-f �8— �y c�y 223 ��� <br /> 5.GcieratWs Name and Martha Addmss S�Gerterata's Ste Address(if Ciifercnt than maii:ng acdress! C3 U <br /> HyPanex Hyypponex <br /> LI Box 479 23390 E Flood Rd <br /> LINDEN CA 95236-9488 Spencer Czer <br /> rCLEAN <br /> tors Pftnne. 209-887-3845 LINDEN <br /> snorter 1 Coma Nan- CA 95.523E-9488 <br /> AFETYq LYEN SYSTEMS INC US EPA€D Number <br /> 7X ROOOM 1205 <br /> Transporter 2 Company Nar s <br /> HARBORS ENVIRONMENTAL SVC INC. !t.s.EPAtDNtt be <br /> htAD039322250 <br /> . estnaed Fac l}t<ame a td s ra Adtress CLEAN HARBORS EL DORADO, LLC <br /> U.S.SPA ID Number <br /> 309 AMERICAN CIRCLE <br /> Fadiys <br /> EL DORADO , AR 71730 <br /> 870-863-7173 ARD0b9748192 <br /> Pttone: <br /> 9a. 9,7.U_S DOT Descnptwn(rr�eg?roper Siv lg Nance.aazare Class to N;nwer 1C Centaire s <br /> HM ark Packing Grol.'P fd anytt it.Total 12.Unit 3.;waste Codes <br /> No Type Quanfty Imivot. 1 <br /> tc X 1 UN1210 WASTE PRINTING INK RELATEDP F00 DQl0 <br /> 0 MATERIAL, 3, PG 11 1 D007 <br /> � � `? <br /> z c� D03 <br /> 2 214 <br /> c� <br /> 3 <br /> d <br /> f <br /> 14.s !t+and&y Ir slr taipns ora Addbonat:nicm atrun TgD:EL 80235624 HY 11856 <br /> CSG: <br /> 1)ERG#129 ck 0 a-� Cc bLQ , <br /> 24H ENERGENCY#800-468-1768—CH/SK/TFI—Contract retained by generator confers a ency authori y <br /> 25. GENERATDR'SiOFFEROR'S CERTIFiCAT10N: E hereJS declare tat thx Contents of m s ca,,zignment are fully and accurately descnbed above oy the proper sNppiN name,a d are classified pac aged, <br /> marked acrd IabeleCTxa�rdad.and are H reSpeCts in grope cxrd t s to V ans,�p, riling to <br /> apd.cable ir:ter;aa;r4ssa'and national owe nom! <br /> Exporter.:ce Afy mat Lie CCn ents o' us CdnS 9 egufat xts-tl exfY t 5t1$x ter t and I am h+e pr In <br /> grrnent 0Mton�i ifl the temis of ibe a lacked EPAAdmnsCedgrne cf consent. <br /> I certify that Che waste r inimzation statement Pden6Fied in 40 CFR 262.27(a)(d I am a targe quanMy generator)or di am a smatt uan <br /> (tt}f v �'gen raMrr rs true. <br /> Genera ?s+Offeror3na <br /> s Pnntedrryped Narne Sxtur Month Day Year <br /> X ,U/ f� <br /> H, f6.Inma onai St ipmenls <br /> Z On tmport to U.S. EjExpa1 from U S. Port of entylexit-- <br /> Transporter signalwe IV exports only)' ('.te leaving U.S.: �- <br /> W 17.Transporter AdkraA4e omen?of Receint of mafedws <br /> W <br /> er 1 Pnnledlh Name Signattae <br /> aTjQ l.2 � <br /> / <br /> e( yped Name 5gna° j <br /> f8.fhscrepancy <br /> 183.Discrepancy fncicauon Space <br /> ❑ t T. r� <br /> � LJ Residue ❑partial Regan U Fug Rejection <br /> 18t:Atemaw Factktyior Generator`. Manifest Reference Number. <br /> U.S EFA!D Narver <br /> � Faclity's Phone'. <br /> w t8r.Sgnat:xa of Ailerrbie Facility(o-Generator) <br /> � Mcifft Day Yoar <br /> Z <br /> 19 Hazardous Wasil Report Managernent Me,+iod Codes(ice.,codes for h2zaroous waste Irealment,disposal,and resycing systems) <br /> OD 2 <br /> d. <br /> 20.Design Facility Owner or Dperawr:Cer'ri k ation of receipt of hazardous materia s ro caved by tte manifest e t as ndee n Item 18a <br /> Pnnted,<T + ; <br /> 1 $5n 1 ay <br /> EPAForm700.22 Rev.f"t 7: Prev:ausedbons are orsolete <br /> 783792/1175'995 <br /> DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br /> 1 f 78 <br />