Laserfiche WebLink
$m <br /> C „ nilamlu. p — <br /> �'. N <br /> Ow+•t'1? rl <br /> O omr en sa vn eine 12-Itch typewriter) v O <br /> ^ RVOUSpenerororlpNumber RECEIVED DEC I 0 241fl N N _ <br /> 0 UNIFORM HAZA CAP 0 2 8 2 7 7 <br /> �y,45TE MANIFEST 0 3 6 2,pa N O <br /> Ao 1 3 Form Approved.OM9 No.205mAp33 N <br /> ' rJama ane Ma„in9 V"-- Emergency Response Phone s-Manliest Tracking Number (9 <br /> 0 .7 468864 JJK O �' <br /> N .1300S Li S TA IO AVE ENTALSERVICEs (800)424-9300 W <br /> - Generators Site A4dmss to Mlk than malling n <br /> addeszl co�tPTON CD <br /> M <br /> Generators Phoma: 310 686-3400 30221 CD � <br /> _ 6.T`��]pomer <br /> wler 1 CompanyNamefn WORLD OIL ENVIfRONMENTAL S€RVIg£57. 2 Company Name 0 <br /> U.S.EPA ID Numtmr <br /> 8.Designated Faarity Nama and site AddressCAD 2 2 7 7 0 3 6 <br /> DEMENNO/KERDOON U.S.EPA ID Number <br /> 20M N-ALAMED <br /> COMPTON aSTREET U.S.LPAID Number N <br /> Faciliys Pfwne: CA <br /> 50,222 <br /> ga, 9b.V'19-Dt?T Description i O <br /> and Pacfcin G (nelUdIng Pre er C A T O 8 0 0 1 3 3 5 2 <br /> HM 9 roup(d any)) P Shipplpg Name,Hazard Class,ID Number, C <br /> K 1, any)) <br /> 14.Containers 11,Towl V.Unit 13.Waste Codes C <br /> .5rt HAZARDOUS WASTE,LIQUID(OILY WATER) No. Tyfle o ansY wt.ntal, <br /> 2 135 N <br /> tLU DM G <br /> 3. vO <br /> CD <br /> O <br /> 14.S UFlandling lrrstrUctions and Additional information �20 O <br /> EMERGENCY CONTACT:CHEMTREC 1-800-424-9300 WOES TERMINAL:UNION CITY CS NAERG#981.171*PROFILE#913t :4 <br /> OILY WATER k *APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT PARTS WASHER OILY WATER <br /> 15. GENERATOR'S10FFEROR'5 CERTIFIGATiON:I hereby declare that the oonleatsof this consignment are fully end accurately described above by the Prope(shOlog name,and ale dassfied,packaged, 1-1� <br /> marked and Iabefed/placarded,and are in all respects in proper condition for transport according to applicable Intemalional and natlonat govemmental regulatom N exportshipment and I MIM Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAoknowladgmenl of Consent <br /> I Certify that the waste minimiza4on statement Identified In 40 CFR 26227(a)(f I am a large quantity generator)or(b}{dl am a small quantilygenemtor)istrue. Month Day year CCA <br /> Gen toeslOfferoes PrintedlT Name Signalun /� �� O <br /> 16.lntema5ona Shipments LJ <br /> f"t <br /> CD <br /> LJ Import to U.S. ❑Expo t from U S. by -t <br /> � Date IeavingUs.: � <br /> Transporter signature(for exports only): <br /> W 17.TransposterAcknowledgment of Receipt of als MateriMonth Day YearUJI <br /> Signatu a !dY ml <br /> Tra orter 1 PrintedlT me CD <br /> C r MmnN Day year <br /> OD <br /> d !S � Signature .1 <br /> Transporter 2 PnntecVTyped Name <br /> a O <br /> ❑Partial Refection ❑Fu6 Rejection <br /> 18.Discrepancy Type ❑ResiduCD <br /> a (I <br /> 18a.Discrepancy Indication space Quantity <br /> Manifest RefefenceNMI U.S.EPA ID Number CD <br /> 1 Bb.Attemate Fatiliry(or Generator) <br /> _ Month Day YEar CD <br /> J <br /> Faci ilys Phone: O <br /> W mature of Alternate Fac' {or Generato J O <br /> 18c Sig 0 <br /> 0) O <br /> 4, v Q <br /> 19.HaTardoD$Waste ft tylanage <br /> went Method Codes(i.e.,lades for hazardous waste treatment,disposal,and recycling systems � <br /> 2. <br /> 1 Month Day Yea C <br /> �manifest ezcepl as ruled In Item i8a <br /> of hazardous materials covered by Signature st-x <br /> N 2D.Designated Flac+liry owrrer or gator.Certifira6on of receipt <br /> TO DESTINATION STATE 111 REQUIRED N <br /> PnntedllyP�Name 00 <br /> CD DESIGNATED FACILITY rn <br /> N � <br /> N previous editions are obsolete. N <br /> O Forrn 8700-22(Rev'3-05) <br /> N <br /> N <br />