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<br /> UNIFORM HAZARDOUS t . f e rain 1 hn ri r 2. Page 1 of 3 6. m - r ;rn„v Re :,panm. Fhanc 41 filanlfo5l Tracking Number
<br /> WASTE MANIFEST ; ,1 - rl ) ocy 013 2. 3 3 6 8 6 JJ K
<br /> i t?r,n fdrnf^s planr(;:Hri 64,ulitq Attdras5 t in,jr itrd5 ado t 1drn3: (4 dil(etaill Irma m;llin) address)
<br /> AFFY LUBE 4/ 12.11W*l
<br /> 1r„ '1 5H1) Id Si WEST PttiJN'iliLl' E1LLiivG
<br /> WEST S ,rtRANIL14 YO Cry J56�:1 « i 1_3 N I_AIJE
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<br /> ASBUF; Y l NVIRONI`AEIv 'I` AlI 3H %• VICES C A D 0 2 8 2 'i 1 036
<br /> 7 R ust:Gibr 2 t npany 14onr,r U.:i,EPA IU Number
<br /> F# . f7,e rjibltaut Fat ',hy I+ unio znd ttuArJ4ta 4 U 6, EPA ID NuruVer
<br /> ASBURY ENVIRONMEN-iALBERVIGC • CERES
<br /> 1920 MORGAN RD
<br /> CERES CA 9535fi 0AL0003936 0
<br /> 9a,
<br /> Ob U.S. DOT Description (Including Proper Shipping Name, I Ward Class, ID Number, 10, Containers 11 . Total TW,Nol,
<br /> 3, Wasle Codes
<br /> H,y1 and Packing Group (if any))
<br /> No. Type Quantity� NON � RCRA HAZARDOUS WASTE , LIQUID ( OILY WATER) 001. TT
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<br /> 3;
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<br /> 4,
<br /> 14 , Spactat Handling Instructions and Addifonai lnmrmauon
<br /> EMERGENCY CONTACT ; CHEMTREC 1. 800 424-9300 W0r9!TERMINAL: CERES UV P OPRIATE PERSONAL PROTECTIVE
<br /> EQUIPMENT * EMERGENCY CONTACT CHEMTREC 800-424-9340 * TRUCK' o
<br /> 15: GEN ERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment ere fully and accurately described above bytho propor shipping name, and are dascified, packaged,
<br /> marlted and labeledlplacarded , and aro in allrespects In proper candtUon for tramper l ucrwfdiug lu applicable Intarnetional and notional govornmcnlal regulationsAf export sh(pmcnt and I am tho Primary
<br /> L'xportw, I carttry that the coolants of this consignment conform to the 1wif t; of the ajlacl'ietl EPAAckrwwludputunl of Cunsunl
<br /> t ce6ly that the waste minimizallon slatoment identified In 40 CFR 2b2.27(a) (d l am a brge quarility g(roialarj or (b) (01 am a small qupntijy gcrd ralnrjis Ime.
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<br /> ifi lora Goa S1ri:aufifs
<br /> z ❑ Import to U'S: ❑ Export from U.S. Part of an( Wit:
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<br /> Trnn,poder 5ignaluro (for erpnd? Only); Date lepviiig U.S. ,
<br /> c 17. Tran podsrAcknaAiedgmenj of Receipt of Materials f ,th 5 i' at
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<br /> tr: a, tilsuepancyin .f,earionSpzce ❑ Quanlity ❑ Type ❑ Residue ❑ PdrialRejeclion IJ FullRejeclion
<br /> k(nndc�l Ref: rnre Nurnbnr
<br /> 12b Owt,A”, ra �rA(y (or Gcnr elorj U,S- EPA ID Ndrn1N2r.
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<br /> 0 1rc Jr van: of Minn,ntr Foatay (or t: ( klw,ih bay Year
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<br /> IBJ I ia7ardous '0aste Rirpnrt Linnagement blcll,al Cndes (i,e:, fm. t) 5 'Of hazwdaus waste ireafmmnt, dispo<al, and rrr)-df r3 cysl(ms)
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<br /> Far illy Owner nr uper' lut : Cerlifiaalion of rcceird of h;izmd )us rnalcu.ds covered by them , rest cxropl as nded in Item 1Ca
<br /> 1] 4° - Fo, n 87^x • 22 111c ; 7-05 , Pfovicjzjs cdi ion3 aafc' pbrrj!ete DESIGNATED FACILITY TO DESTINATION STATE ( IF REQUIRED)
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