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NON4UZAADOW 1.Ganeretor ID Number —---- 2 Page 1 of 1 S Emergmq Reoppnee Phone 4.waft TrmWng NwOw <br /> WASTE NAN(FES'T CAC002967105 _ _1 6SD-331-8013 NM18061009-a <br /> 5.Genaraloec Nark and Mal*V Mdmu GereraWs She Address M dl(eml then mAW addrMaa) - - <br /> lAPARTMENfT ROAD <br /> COMMUNITIES- <br /> 3D00 EJ�IJTN1009 ROLLE PARKWAY.WTE 450 �. 1E,CA 94010 <br /> SAN RAMON.CA 94W3 <br /> G&WIMM Phone A15419&01(77 I <br /> B.Tmmpoft 1 CW"W Name U.S.EPA ID Nuadfar --- <br /> 'S L ) vxc-- <br /> 7.Tweportat?.Campsny Name U.S.EPA ID frrrrber <br /> 8.1 nd�f1 U.S.EPA ID Number <br /> 77 <br /> 707.432.4627 <br /> Fxili s Fhona: <br /> 9.Waste S 1pRng Name and DescVdon 10.Caaefrera11.TOM 12 ftNo. type Qum* Wuvd. <br /> 1 �vt +u `�iv �On 1 DT 18 Y <br /> - - 2- - - - — - - — --- �.----- <br /> 3. <br /> 13 Spe�PH nft Wkwftm <br /> and AM*on l Inlan:aeon- — - <br /> 19LL TOr CATALYST EWRRONMENTAL <br /> 14.GENERATOR'SlOFFt7t011'S CERTIFICATION,1 horoby tear that fife oorawla d Im wcVwrknt-6*and aavralely des a abow by ft pow shspparp rams, awdasa&K pedsge <br /> marked aril Iabr.9edgfla,5rded,and am in ea respeas in proper mWidw ler Uarupat aocadng to appbc"i Umational and rfatiaad Dare. <br /> Gena teysDrV$Pdnladliypad Name Slprfahfre • No* Dy Year <br /> is Hunwww BtdpakrAs ❑ IL <br /> impm to U.S. ❑E w(ram U.B. Port at vtowdt: <br /> TrmagLegr S"imt m ft npoft aHyl: _Daps bevYfg U.B.: ---- <br /> a 18 Tmmpatar Admmf WVW of Raoaipl of Malarlah <br /> TrAWlef 1 Pdde Wod ` SlgfaWre me* Day Y <br /> Twworter 2 RVrledrlyped Name re Uonlh Day Yea <br /> 17.Dwrepxy - -- <br /> 17s,019mpaney Irdbkon Sp" ❑a-lay ❑Type ❑Residue ❑P-w meow ❑F.9 Repolon <br /> 11 Refewca Number. <br /> 17b.Alt=O Fad ily Of Genaralar) iNF� U.S.EPA ID Number <br /> Fadty's Phone: <br /> 1%Skpmkn of ki-R le Fadlgy(a Go--Mr) e/j O Month Dq Year <br /> 18.Dasignaied Faaly Oww or Operator:C*Scdm of mW d mg*d*sow W by the man9W oxcept as noted In hens <br /> Prhted typed Hama ^ Sig�aturo Mar Day Y <br /> i2O (4m <br /> 16"LC-0 6 10498(Ray.afros) DF.SICiNATED FACILITY TO GENERATOR <br />