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W*4K.AR DDt15 1.Generator ID Nrrnber <br /> llpl aye t of &Effmpncy Rhpom Pho w 4.is U Traoldng Ruwd er WASTE MAWFEST CACCO2957105 660.331-8013 NH18061009.6.S <br /> 5.Gerwata'a Name and IAa, Addtate GetwaWs Sae Address(H dBerent Own ma*q address) <br /> SUMMERHILL APARTMENT COMMNITIE8. <br /> 3000 EXECUTIVE PARKWAY,SUITE 450 1009 ROLLING ROAD <br /> SAN RAMON.CA 94683 &JRUNGAME,CA 94010 <br /> Generator's PIK". <br /> S.TmmprrW 1 Comport'Nein (I tj U.S.EPA ID Number <br /> 7.DTmnspoorbw2 CooprelnaynName U.S.EPA ID Numbw - <br /> g- t�7 t;ri=�C,r7t1 'd15�g11p►'rCs I U.S.EPA ID Norntw <br /> 3675 POTRERO HILLS LANE <br /> SUl",CA 94585 <br /> 707.432-4627 <br /> Facil' 'o Phone: ' <br /> 9.Waste SI1lpping Name and Desalptim 10 Contatrrem 1 i.Tow 12 Unit <br /> No. Type due* WLNoi. <br /> I. No rVd1�STE S — SOIL) 1 DT 18 Y <br /> i <br /> 2 - - - ----- - - - ---- -- - <br /> 3. <br /> 4. <br /> 13 Spec PNLncling F 18 333 ns and Adffwxe lutommlan — - <br /> E0.L TO[ CATALYST ENVIRONMMAL <br /> 14.00IERA70RVOfiOW'S CtniUT1FICATIOW I hereby declare that the canW to of Iftie rxnmlgxrrerd am t*and eauaUely desert ted abo"by the prcf•;t 0ging name,and we dasmSed,pedagK <br /> Mend and fettelsdrplecarded,and ara in aH mepacda m ptopet core%on for transport aceadng to appktrik r*wr at=W and rt*XW govwnr aaoru. <br /> aRJtfoWest.PonledlTyped Nartre 31sp+alu o ' r.lon h Day Yet <br /> I til- SU Amer-444-- PAZ <br /> 15 krhrrldotlel�dpmnds U.S. Port of i <br /> '�I rr'' <br /> J Import m U.S. u Export rons erdrykidl: <br /> Treti3podar Sgneture(or e, Lpns txiy): _ _Dale brAig U.S.: _ <br /> cc it Trarrporter AdnonbdWrwd of Fboalpl of Nalarlala <br /> Tr+nporler 1 PdrbCyped NemoSlproWra - mom pay Year <br /> Trarporw 2 PrinWVTyped Neme glgns m Month Day17 Dacupwq <br /> Your <br /> I <br /> 17a Dismp ncy In*dm Space m auffm ❑Type ❑Residue ❑Peru%).wm El hi Ra er, <br /> Kindest Relorence Number. <br /> 17b.Ahoma'A Fw'Ry{a Generator) UA EPR ID Number <br /> LL Facdity's Phone: <br /> m.signaktre of Altsmate Fadfly(or Getw*r) mmfh Det' rear <br /> 18.Designated FaaMy Oamr or OparaW..Corgadlon of acolpt of mWod tla by rh6 ki except ay uoD rn hem 17a <br /> Pri tmYTyped Name g wute - - -. -- Month Day Year <br /> 4� <br /> 16"LC-06 10498(%v.91109) •'�� DESIGNATED FACILITY TO GENERATOR <br /> Sys <br />