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W)NAAZANDON II.Gonararar ID Number 2.Page 1 of s.Emergency Reeponov Phare 4,weaea TredIng Nearber <br /> WASTE NANFEST CA 710b 1 650331-8013 1dM180610g9-f 1 <br /> 5.derreratde Name%d Mw ft Addrere CxneralWA Sno Address 6 ditmrd rban mAng address) <br /> VJNM51KLAPARTIrlENT COMMUNTF-S. 1009 RQWAIS ROAD <br /> 3000 E eCUTIVE PARKWAY.S?(JITE ASO 1 WS R I'3LL CA 94010 <br /> SMI RAMM.CA 94683 <br /> Geeeracm Phx <br /> 6.TISM 1 GOrttpary Name i U.S.EPA ID Number <br /> �- <br /> T.T 2 C9mpony Nerno U.S.EPA ID Number <br /> 113B7"e�f U.S.EPA Ip Namber <br /> MMMA S8"US LANE <br /> 6 <br /> s Phone: 7OT-432-46+£7 <br /> 9.Waste 8K*V Name and DoswWc n � II.Tow 12 Urdf <br /> Nao' Type ",IN* WWd. <br /> 1. E SOIILj 1 DT 1$ Y <br /> i <br /> 2, <br /> 9. <br /> 4. <br /> 19.Spada)hle Iesivotions and Adftorml Infomratlen <br /> 1)PHLF0333 <br /> M.L.TC: CATALYST EWRONMENTAL <br /> 14.GINEBATOR'siA7RNMIS CERTIFICATION:I hereby declare that the oxherrh d rhe cmral¢eoerrt era(idly end awntely d=WA Above by nre prWor ehpptrrg name,and are daasied,padu0ed <br /> marked and labelediVocarded,and are in al reoopp#ec[s mops or prax0on firwUpmtaemk"rokS to Wpaifovdiari ernd nalaxre0 tldw <br /> al^rora Pdmed Wed Mu1900 a Mornh Day YM <br /> is kkma4onA1MOM* ❑Impod ro U.S. Bow f m U.S. Part of arrfryhk <br /> T r Simwwrs a da pate bwM US.: <br /> it 16 Trarrportar AdmarWgmmt of BWW of Mftials <br /> T1 Pdntedn"d NOWSlgxd Mwo Usy yor <br /> 7-4 vRw^In'E)ER IIN 10'7 14 <br /> Transporter 2 PrInleNTyped Name Sgrnture MMM Day year <br /> 17,D*mpwvey <br /> 174.D[aMMIq Indcatlorr Space 0 OArltty Type ❑ ❑Peru Relecnon ❑F.1 Rel d. <br /> MaMeet ReWww Number: <br /> M Allelileto Fedlty(or Genaator) U.S.EPA ID Number <br /> 17a.S)gnalrrre of Asomata FadTiy(or Generator) Allf 0HIM11MIJ. v Mmlh Day Year <br /> o JUN 0 <br /> �urnFx:l►�w s LwFlu,M. <br /> 1e.Dealynarod Fao(iIyDrxrar or Operate:C% n of receipt of rwle Ws covered by the raeniect except as <br /> Prinisd'fyped Hama Month Dsy Year <br /> 16"LC-0 6 10490(Rev.9M) DESIGNATED FACILITY TO GENERATOR <br />