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Piease II or typo (rem (Fr•,r. n d for use on elite 02,l,ilcln) ty)I(,t af:C,) <br /> FormAt ,rr�•r;;1, Q;MB Na. <br /> UNIFORM NAZAROOUS i • Gene a;ariD Number 2 Page 1 of 7 mcrg n F r e , }r e Gbore 4 + , rnrik*r rae�3ng t:un bci <br /> CAL000182n4r 1 (800) 449300 018233 399 JJK <br /> WASTE MANIFEST — — - ---- E <br /> irtzrc lu' P a�, aaJ . .�,z+ npty tt��., Cenur:rinr'.; SihiAi ,,;,;t fit !X! w4ititrammaitinv 5 resn� <br /> JIFFY LUBE 112497 <br /> .1471 SHOR € S'( CA 956ri1 4 i 1 � I4 . V>tE5T LfiNE MONTHLY I3iLL( 4IG <br /> WEST SRCRAIYIEN20 r f STOCKMN CA 95210 <br /> i,;Lgq. atiu'sNh�n=:: 209 9�2-1662 l <br /> dityi.a=.a C A D U 2 8 2 7 7 0 3 C <br /> ASBURY ENVIRONMENTALSERVICES <br /> 7. Tran;3'c;t.r 2 Compxrtyt.ad'.ti <br /> S- Vr ,i tcJ r t y fllnin and Silo Address U.S, U, ;I ID Numbar <br /> US ECOLOGY VERNON INC <br /> 5375 SOUTH BOYLE AVENUE <br /> LOS ANGELES CA 90058 GAD 0 9 7 0 3 0 9 9 3 <br /> Facitity'sFiono: (3� �y7 500 <br /> 10. Coni-ln>r 13. `Nasto Codes <br /> 8z. 9b. U.S . 0GT'Vesuiption ;acluding Proper Shi pir�g Name, Hazard Class, !t) Numbar, - 11. Total 12. Unit <br /> HM acrd Parking Group (d eny)1 Na. Type Quantity \NtNol <br /> 1 ' NON-RCRA HAZARDOUS WASTE, SOLID, (OILY SOLIDS• PAPER FILTERS) ] l 352 <br /> DM P _ <br /> ku <br /> �... <br /> is ,v;n Iiirsd,rro, t14 YF. •n58(14A4'SLin ufItIN ni <br /> EMERGENCY CONTACT : CHEMTREC 1-800.47.4-9300 WOES TERMINAL: CERES CS NAERG# 9131 : 171 * PROFILE # 9B1 : AP <br /> 19221.0 OILY SOLIDS-PAPER FILTERS * P560.00051514 * APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT / (, <br /> z5 Gt:Ta'RATU;I utfaFF RtSR`S Lt;R'feFICAYQtic I heroby d;csrd iia! the <br /> antdenis of tits rogs(grI ore tiny u.>?f acctr€atoVy daseritrad aura by the prnpar $Ipp�nn, nIV aro nrs ,?a?. <br /> marked and tabolcd)Vacarded, and are In ail respects In pro-par condiltcn for transport according to appiioabla intwt ! oral ar naGunal governmental regulat�ns; I! ozpottst$mantar d i a,.11 a Pri rarf <br /> Xpe!ter, ! 'cotry that the contorts of ( s ra^ntw onl oontarm 10 the terms of the aitachod EPAAcknoviodgmentof Consent. <br /> i ce'4iiy L }t the waste rc nlmizabon statement identfa f In 40 CFR L'tf2. 7 •n a t em o k2. o I son ''y ,ere. ib r) or (b) (If t am a small qu aaiil j gdisGru(or) is trio, <br /> ° t ) l Rl r — <br /> �nn _7f <br /> r Ju in .;nr,eav ,t } ,tY: n : D kn ri to U.S. EJ ENNUI Lwn U.S. Port or onrryfoAl: <br /> z 7mnsrctnr .knnt;rtelt, re , t: u39 i <br /> Date lsa'f'ngtU-il-r _ <br /> 7 TrompOlerA.+knoyAadgm ;I Receiptcrt+t2tsctais _ <br /> Tr? r�•tsrl PrmLdlTyt:o '. tL, ;rn '•'. �'i,btlr�x,, _ t3:rr'1a,, 0 <br /> ;ffgi�J <br /> Jr , 2: s � Pns "'TSR; it. 'r. c..:ur-r Ooh hof 1'rr <br /> 14 EI <br /> 19a l3IWapat y InriaOR. Spau (leant ty I TYpa ❑ Re5ldue tJ Far".ial Rc octicn ❑ Fedi Re)edon <br /> 18b, hRern,t2 rr Allj I*T Cxerrakt) <br /> ..r <br /> t� <br /> LItII. Frr,.+:.,Ir s Ph^no: r <br /> lum +_ _ . r ; rrw c , t. n�ata;t ,,. aur flay <br /> z <br /> 19. ti�z cd u , ns a�a1 I.Ianagemonl ,cThon Cri as Q o , tom us kr haze.±does araflt7 tram n;, p`^ kali I r t, ss) <br /> ni trt,, . rc, <br /> UJ ll�� <br /> C U s ' ri F c. -.; v,:rar 0 f Opel Bic r. Ct rf.;.�':v� bl. ra:aptef na.�a;doe: matena;< c^,�s'ete6 by lot Willie" Crc Ft :e ndr3 tr, item iiia a <br /> r[m 4+ F ' ! 1S1}� ,i. reattie 21h"i , ,nq Yn� <br /> t�t <br /> EPJef6+m9 *100 22. IRev 3-0S) Previrr,<se 'i6n4Rrt, obelele DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />