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WA41AZARDOW 11.Generator ID Ntxnber 2.Page 1 of 3 Emergency Plesppnae Ptm 4,Waste Tracking Number-— - <br /> WASTE MANIFEST CAC002957105 1 650331-80'13 NH18061 DD9-.Y j <br /> S.Generatoh Nameend M As*m she ( ddhferert than mWkg aklress) T <br /> SUMMERHI LAPARTMENT Cola umT1E9. 10ii9 ROWNB ROAD <br /> 3000 EYBDJ VE PARKWAY,SUITE 450 1 f 9 ROL11dE,CA 44010 <br /> SM!RAI W CA 94683 <br /> e,Ti mnopalvr 1 Lo rgany Nares UR EPA ID Number <br /> 7.Truns-M+r 2 Company Nrtm U.S.EPA ID Number <br /> — <br /> U.3.EPA ID member - <br /> Ma HUS LANE <br /> .I aas� <br /> 707-437 <br /> - 10.CM%klers 11.Total 12 Unit <br /> g.Wade 9Nppilg Name and Descrlptbn _ <br /> _ No, Type Dumliity WLNoL <br /> 1. E 5 SOIL) 1 DT 1$ Y <br /> i <br /> 2 - - - <br /> m <br /> 4. — <br /> 13 Special Handerng InsiruWons W Addlionom Inkmnatlon <br /> 11 PHLF 18-833 <br /> O L TO: CATALYST ENW20*dENTAL <br /> 11.WIERAf0R'>if0fF1i10R'8 CERTlFICATION I hereby bctYe tlxit the Frac rte 01 d a:ix;:imrtx ret BR lu y end aoamlrl7 deaccmed above by I1m lvoper shrpprlq dame,and are daseiad,pecieged <br /> mMbed and Iobdc4VaraWW,and are in all m spmx ss in proper con don for Iranspon aaordng to appk:abb mmmatcxW and rrsiaud governor anons <br /> wt'Memm's prmlmxUiyped Nemne �� � $�adure hbrlet Day You <br /> tjeppii��77 r`t'�9 <br /> 15 k6rndlonmd ShipmentsIr <br /> �f�-tt K <br /> ❑Impod to U.S. l�l kapott Mom U.& Part of <br /> artyka.- <br /> Traromorlef Sjanawm fore As Draio WMng U.S.: <br /> Mc 1Q Tramsmpache Adrnarrledgrrrent of Reoelpt d Materials - --- - <br /> Trmpoiter 1 PdmtedaMxd Name - — ra momDay Year <br /> �' <br /> Tmrupar*2 Pdnlgeyped Name - - Month Day Year <br /> 17.0sarepancy -- - - - <br /> f 7a Cisempancy IndWon Space fhreflah ❑Type ❑R.M. ❑Panel R omw ❑NO Fbod. <br /> Mwftd Reforenco Number. <br /> 17b.MM"FBdlly(a Generator) U.6.EPA ID Number <br /> Phone: <br /> Faa�s / <br /> 17c.Slgl do of AHemab Fad*(o(Gerxralor) I {,yMmh Day YM <br /> ie.Doa7 naiod Fac*Oanor or Operator.Cw§Datbn of ax*t of mwwbk ewv►ed by th matlifeet except as m fliffiffs <br /> Pml*Wfyped Nan» Sigreture -�- — Month Dol' Year <br /> y6 <br /> 16"LC-06 10498(Rea.2M) DESIGNATED FACILTTY TO GENERATOR <br />