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NON+IAZARDOUS 1.Generator ID Number `- - - Puge I of .1.Finwgwq Rospo PPlwna 4.9YYb Trading Number <br /> WASTE uArAF ST CAC002957105 I 1 [ 650-331-8013 I NH18061009- <br /> G.Oet*rata aNana fel rAz!`rg Addnas - - Generator's 8k Addtees(W dAlermt ftn masrp edMe35) - --- - <br /> SLHr1hr1ER}iILLAPARTMENT CtXr muTes,E1ON009 L�IS ROAD <br /> ROL <br /> 30D0 eMMVE PAftVAY,ANTI=4SO 1 1 W9 R OL ME,CA 94010 <br /> SAV RAM .CA 94683 <br /> Gcna'atorsPhore. dj;}-93d-01b7 _ <br /> 6.iranapalar I CompanyNsme <br /> u.s.EPA ID Number <br /> r � <br /> 7.Tnuroparter 2 Company Nemo U.S.EPA ID Mrebr!r <br /> 8'DoV""JeRU.S.EPA ID Number <br /> CA S86 LANE HLLa <br /> 707.482,4627 <br /> Fade s Phone: <br /> B.Waste S*pag Name and Deealptlon - 10'Camaklers 11.Tobi 12.Unit <br /> No. Type auNdy wwd. <br /> 1. NORFQ571{ASTE S D HA7ARdOUS SdIL) 1 DT 18 Y <br /> z -- - --- ------ - - --- -- -- I <br /> m i <br /> 3. <br /> 1 <br /> 1 <br /> t <br /> a. - - <br /> 13.Special Flvndb" Instructions and AdrliOonal Infom edon <br /> 1)PHLF 18 .333 <br /> TALL Ta CATALYST EWIRONMENTAL <br /> 11,t BMRATOR'C(OFFEROR'S CEATIPICATFOW I hereby Roam that the ooaents of ft carsipunent ere h4i and r.=ra'xly described above by the propor shg4ng name,rid we cl asied,peckaped, <br /> marked and 6'belod/p6c3rded,and aro In 6A roepects mnppDper condhbn Ia Transport accodng to"bakbW ancerer'onal end no rdaams. <br /> GoaMlafaUffames� yped Nan* aV ---- soutura�J� . r Monlin Day Year <br /> t5 Intemadonal Stdprrerds <br /> ❑Impel to U.S. ❑Evm(nim U.& Port Of ertryJadt:- <br /> Tramporter Swalure a rts OWar leaving U.S.: <br /> ¢ pr�errt 18 Transpoft Adrnoaledof Reoelpt of IWarlla _ - <br /> Tramporter 1 Pdrited fyped Nano S"wre Morm <br /> Day Y!M <br /> C"/ h, '16= 13 <br /> Trmspater 2 PriftwOyped Name 7 SlpmWro i„ - Month Dur Yew <br /> 17.DiwWaro <br /> I Ta Usaepancy IrdlaWn Spee ❑otvY ❑Type ❑Residue ❑Perw Re]acb. ❑%I Reodon <br /> MxWosl Roterence Nwter. <br /> 17b.AIIwnate Factily(or Generator) - U.B.EPA ID Number <br /> Facifitys Phone: <br /> 170,Slgrftm of AfWn*Faciltty(a Gone-Ar) Month Day Year <br /> p I <br /> i <br /> 18.Designoled Faddy 0"or OpenMor:t'w icdm of nK*of mWvd*t xwW by ft.=, erlco as noted In hen 172 i <br /> ted/TypedNam+ SVmtunr 1 ----- IAunth bey 1 <br /> IWBLC-06 10498(Rev ) DESIGNATED FACILITY TO GENERATOR <br />