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NON4W WDM 1.Generator 10 Number 2.Page 1 of I S Emergency P,oaponse Phone 4.Thele Traeidnp I urber - <br /> WASTE NAMFEST CACt7 2MI05 L 1 �53.331-8013 NH18061009-fi� <br /> 6.Gwwratore Nome ax1 I.U'Ihg Address — Generators Ste Address(r dllerert tlran mehp address] <br /> L APARTMENT comm JNTIES. <br /> 8040 EMKUT1VE PARKWAY,WTE 450 1009 ROLLNS ROAD <br /> S-A� N RAMON.CA 94588 BLIRLINGAME,CA 94010 <br /> Gwwa <br /> B.Tmnapcxter 1� 'n ` U-S.EPA Ill t•!umber <br /> 7 T,m"bi r 2 tlmnyeny NmnB - -- -- U.S.EPA ID Nun'ber <br /> U.S-EPA ID Nomber <br /> MOM94585 LANE <br /> 707-432-4627 <br /> Focal <br /> e.Waste Stippag Name and Dewroo r - - —— 1Q Carl kw3 11.Tobi 12 Ural <br /> M. TV@ armory mows, <br /> 1. IWwAs7E SOLID(NOIw�S 1 D'T 18 Y <br /> 4. - <br /> 13 SWW Handft lessvctlons and Addttonal Infornnakn <br /> 1)R41-F 18-333 <br /> 891.TO' CATALYST ENVIRONMENTAL <br /> 14.QBimT0A=FF§R0FI%COTIFICATIOW I hmeby dsotme that the cortarrb at ft eomfunamt are to/and emvatcly above by the proper ehglprg name,and we dusfied,pedwed, <br /> marwd and LIoele Mawded,and are in eA relyr¢cw m proper condltlon lar hmMood eaordng to eppbcehle srtarnanovernonal and nabovar gaeons, <br /> GeneLworsUffemes PrxderVCyped Name. Sy <br /> � � r►aNm� � NtmOr pay �Y� <br /> ��yi, <br /> 15 Intemadonal StrOTW is { <br /> ❑Intpod m us. Export from U.S. Port at enigk I:- <br /> Trmsporter S nature(kx exports Data baykg U.S.: <br /> 1d Trer wood Aduravledrmt at Receipt of 111derllls <br /> Transpork , �Ar7_ _ <br /> Tramportar 2 PdMeNTyped Name S"turo Morrlh off Yw <br /> 17,DwmW)q <br /> 17a.Discrepancy Irdicaaon Space ley ❑Type ❑Rb. ❑P-mw R-iaton ❑Ful"dan <br /> Warklast 1"ranco Numbdr. <br /> 17b,Allmift WRY(of Generator) U.S.EPA ID Number <br /> Fadery's Plane: <br /> 17c.Signat<rre of Alfemate Fadlty(rx Gene alorj Month Day Ycar <br /> 18.Deagnaled Fealty Omer Or Op URW..CWlkdlon of re 4l of mt Wlais grated by the manifest except ae noted In flern 179 - <br /> PVnNTyped NMta Sigdure -- ------- Month Day Year <br /> 16"LG06 10498(Rev.9408) DESIGNATED FACILITY TO GENERATOR <br />