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f044 At.AADDUS 1.Generator ID Numbe 2.Page 1 cf 3.Emergency P4glor=Phase 1.lArW T=Wng*A9W -— ----- <br /> WASTE MANFEST CAC002967105 1_ 650-331-8013 NH18061009- <br /> S.GerwaWs Nerve and -- - -- <br /> g Addreoa Gerxirefr>rs Soe fc >a(R dplerert Thad ma/rp eddrose) <br /> SLWAVY**LAPARTMENT COMMUMES.-NM 150=1VE 1009 RQLLAt9 ROAD <br /> SMI RAMON.CA 94M SUfTE 450 &URLAVGAME.CA 94010 <br /> 6.Trene 1 Ca Name U.S.EPA ID Number - <br /> eT <br /> �k ; 75 <br /> 7.Trmaporter 2 Comperty Nems U.S.EPA ID Number <br /> A67j' "av 5(y# U.S.EPA ID Nomtw <br /> FUTCAE d 5HLLS <br /> 5 LAVE <br /> 707-432-4627 <br /> Fadli 'a ftoo: <br /> B,Waste SNppwV Name and Deecdpdon — - 1Q. 11.TO* 12 lhdl <br /> No. Type Ouw* WCNo4 <br /> 1,, l o bpi VN som 0—a�RCOUS SOIL) 1 DT 18 'Y <br /> 2 - — --- <br /> s. <br /> a. -- - <br /> 13.�1}F}{L.F 8*kuotioria ad AdMonW Int mwoon <br /> INAJ-TC: CATALYST ENVIRONMENTAL <br /> 14.GENERATOR'S/OFFEROR-6 CERTIFICATION I I reoy do ee fNit Me cu;?rnt5 d rhn carLY9; -ii ere bury r:c4;:urntely: ,.r;==d by 1143 popes 511,p :, name,wd are dnoded,pe� <br /> narked aixl UiWecth4awded,and are in aM nape=rn proper to-4don for Trans?on s=dng to aWbcabta uitoaWtrural asst whoryl ga�ernm .1 gTlnaons <br /> Gen "orora NntedyTypcd Name Signature AIlif <br /> Monih Gay Yaw <br /> 15 Internado?wf shonarts f A m U.S.mpo Evm kem U.S. Port of fdlykodt <br /> TrmDortrrr S rabue fore rN Delo Lvyhi U.S.: <br /> w 10 TranspnrmrAdnorrledgmerTtofRoom"d►WerIW - .. <br /> Trarpmlarl Pd Name J SlgnaWfo M* Day Year <br /> TrAfstrader 7.FMnkWyped Name Wane MuM Day Year <br /> 17.pecrepimcy <br /> 17a Giso ywxy Ir*dcn Space Flamm, ❑Ty" ❑Residue ❑Pow ❑Ful Re)W. <br /> Wavle d Hc.'erence Nim1mr. <br /> 17b.Aflor a:o FAM(or GerTambo U.S.[PA ID Number <br /> FaatY o Phow <br /> 170.Span of Al MW FWAy(or Geri or) Monti Day Yeef <br /> 18,Designated Fack Oanor or Operabr Ce1IWIli t1 d roo*of mWrbk mvwW by do R1w?Keet except a noWd In fITmT 1711 <br /> PrintrrdrTyped Nnme , Shp mordh D of <br /> I�01 <br /> 169-BLL-0 6 10498'A -ww) DESIGNATED FACILITY TO GENERATOR <br />