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NON.}1AYAA DDUS 1.GonerWor ID Number 2.Pegs 1 of &Emergence Response Phone 4.Wars Traoldng Number <br /> WASTE fitANiFEST CAC002957105 i 650331-8013 _I NH1$0610D9-ok <br /> S.GerwalDes Name and MW"MOM Generator's She Addmse(9 d9foranl th"malls g address) <br /> SUh*AERHILLAPARTMENT COMMUNITIES- 1009 RaLLWB Rano <br /> 3000 EXECIJTNE PARKWAY,SWE 450 �,CA 94010 <br /> SAP!RAMON,CA 94683 <br /> Gonaraton+Phone. 15.994-01(77 <br /> 8.TmnspoRW 1 Company Name — — <br /> 7.Tmmporror 2 Cwpeny Narre � I U.&PA ID Number <br /> &Deod"b"219�� U.S.EPA ID Nomtr <br /> b <br /> 55 <br /> SUISI POTRM 585 S LAME <br /> 707-432-4527 <br /> Fade 's Rano: <br /> 9.Waste Stopping+lame and DescrVon - -- - 10.Cmtaktars 11.Total 12 Unit <br /> No. Type OUNY4 duvet. <br /> 1, NO U TES 5011) 1 DT 18 Y <br /> 4. <br /> np33 13 <br /> 19.Spe;aFNLF 1&oeruc6ons arxi Addisor�t intonnadon --- 2� <br /> ) I. <br /> M L.TO; CATALYST ENVIRONMENTAL <br /> 14,GW ERATOR'&MFF5ROR'6 CERTIFICATION:I hereby dedore tot ft mrnmla of ft crimimment we futy and aomrately de-.-,nbcd above by the propor ehippng name,and ars dass&3d,padraged, <br /> marked and labekadptarmled,and are In all mepeus in proper eondidod im transport accordng to Rocab{e«aamah"and nese d qvmWo0v000ticna. <br /> GiniqpWrmfforoes Pnnioi typed Name S yrdlum • MDnkh pay Year <br /> 15 Inwradonal Shipow_als !-- <br /> tJ Impod ID U.S. O ExW frM U.& Part of erdrylaxt <br /> Tram r Srgnaturo nor export wiy) Delo Iming U.S.: <br /> aC 16 Transporter Acknowledgtw it o1 Flow i d Mo*Wo _ <br /> Tram J Pdrdpdriyped Two, <br /> Day Y <br /> Transpodor 2 Pd Name ee - - — - Day Year <br /> 17.Dia qw cy <br /> 17a CAscrepancy Ind+"aton Space ❑any ❑Type ❑Reo#iue t—f Partial Rejew. ❑Fu1 Re)adton <br /> IArodesl Rehrcixa Number17b.Attemals Fadkly(or Genemtw) U.S.I-PA ID Number <br /> FanTd s Plane: <br /> 17c.Signature of Ahcii t Facilelyfor GGert tor) ��yf I.bnth Dq Yee1 <br /> o , <br /> 18.Designated Faafty Owner or Oporolor:Cwik@Wn of receipt of melu Ms wrercd by Out rnandest except 170 <br /> PmWyped Now Slgwture -- - M,w,e, Day Year <br /> 169-sI-C-0 6 10498(Rev.QM) DESIGNATED FACILITY TO GENERATOR <br />