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NON-HAZARDOUS 1.Genemw ID Number 2.Page 1 of 9 Flnergerwy Raaponss Phare 4,Was%Truidng Nwdw <br /> WASTE MAMFEST CA1�b7105 _� t 650331-8013 NH18061009-� <br /> 5.Generators Name and Maldrp Addiaas GeneraWs Sera Address(R dlfareni Yvan mA ng address) <br /> SLIP LAPARTMENT COeNLV.IMTM. 1009 ROLLINS ROAD <br /> 3060 E7®CUTIVE PARKWAY,SUITE 450 E!URiJNGAltdE,CA 94010 <br /> SARI RAMON.CA 94583 <br /> Geaaraoors Phone: —415494-007 <br /> _ <br /> S.Ttaeaporw 1 C""—' <br /> 9 U.S.EPA ID tdumW <br /> �J � ,� �� t�;, ti <br /> 7.Trenspoitor2 Coop"Now U.S.EPA ID Hunter <br /> &Des( U.S.EPA ID Number <br /> 0 HILLS as LANE <br /> 707-4324W <br /> F s Phone: <br /> 6.Waste Shippitg Name and Dwalption 10•ComaNers 11.Total 12 Unit <br /> No. Type Qum* WtNat. <br /> 1, E 5 ) 1 DT 18 Y <br /> 2. <br /> 4. <br /> 18_SmW <br /> Pi Handft <br /> 18x333 ns and AddlI"W Intomiallon <br /> W.L.Ta: CATALYST ENVIRONMENTAL <br /> 14.t1HEUITOR'&0Rim S CUMFICATI01l•I heraCy Mare that the cora is W lm oonsVmwd sm tally and arzvtstely desubed above W the proper shopng reme,and are dasdk4 pa*Vod, <br /> nftd and(apdadiplecardW,and are in sA reepecta in proper ocrd don for ftWort aocordng to Wpicabla M-st"and nnriorA qwmmmvfyv0ftbwAL <br /> G aOUsrot%Priniem*dName Sipulure • Month Day Year <br /> 15 kdemodond Sider w b El I"to U.S. LJ Export from U.S. Port of a&pwt <br /> TwoonerSkindum e vis. DW lemkV U.S.: <br /> ac 16 Tmuporrar Arfnmvlsdrrrarnt of Reoalpt or Matelots <br /> Tra+>sporter 1 Pd Tyµsd Hwn1� SigrrWre; Mel Dey, Year <br /> Tranapm*2 Pdrmadrfyped Name Month Day Year <br /> 17.Dia� <br /> 17a.Mwepan y lmkstm Space ❑ H ❑Type ❑Residue Par9al Refection ❑N1 won, <br /> IAmlfeat Felenarca HurrBer. <br /> 17b.AAarrWo Fwft(a GeroatoO U.S.FPA ID Number <br /> Fac*f3 Phone: <br /> 17c.Slgrret m of Mmutle Favi ty(or Gsneralor) /y�r� Month Dsy Year <br /> J <br /> 8 <br /> FAAad18.Daalgw Faafiy Owner orOperator.Cert cdm of mc*of insladala coveted by the manliest as rlem 174 <br /> P drrypad Herne <br /> h Ray Ysu <br /> 169-BLC-0 6 16498 mov.silos) DESIGNATED FACILITY TO GENERATOR <br />