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NONMAURIMUS t_GewmW 10 Nunber -�` 2.Page i of S.Emergency AWrm phone 4.Eaobs TgTwng P°—W <br /> WASTE t1ARFEST CA1C002957105 _ 1 --650.331-w3 <br /> S.Garorabr'e Name xrd hL:.fnp Address <br /> V &fATaWs She Addrm(8 ditert gran MON eztdra$,) -- _-----_ . <br /> SLVAMERHLLAPARTMENT COMMUNITIES. 1GO ROLLINS ROAD <br /> 31)60 EXRXMVE PARKWAY,SUME 450 2lJNGAME,CA 94010 <br /> SAN RAMON.CA 9Ma <br /> Genormu's Phuro- <br /> 6.TmnopWW 1 C010"Name <br /> U.S EPA ID Number <br /> 7.7r3mporter 2 Canpeny Hama <br /> UA EPA ID Number <br /> S� � <br /> MU.S.EPA ID Number <br /> A9HLLS LANE <br /> 9+IS85 <br /> 707432,4627 <br /> F Phone: <br /> 10.Conlalrrers 11.AN 112.Ud <br /> 8.Waste ftp4 g Name and Dewrodw No. Type cwa" "o. <br /> 1. [y MAZARDOUS SOL) 1 DT 18 Y <br /> 77 <br /> W 2. 1 <br /> 9. <br /> i <br /> 4. <br /> i <br /> 19 Speck)Fla,ding lochOons and AdMonal hdonrra lon <br /> f)PNLF 18-333 <br /> BILL TO: CATALYST EW ROA MENTAL <br /> 14.GENERATORI OFFQIOR'6 CEFMFICAT101k I hereby deatam that the omw to ct tn9 ca,,:lgnmctritrotully and a[crxaWly dewidred above by Ute AroPQr sli Qpgg warm,and are daaeied Pte, <br /> madmd and wbdodlpiacmtW.and are in ell mpKis in proper wndttton for har&port accadng to aPp c"crMe daW end n*wA qmmVftVW0om <br /> G sR a PdNedlfyped Nome OWLStgneture A Nonlh Day Yam <br /> J IA <br /> 15 hrrwnadonal Sldprnerds ❑Impod to U.S. O Pew iron U.S. Prot d antrylmdr <br /> T r (br axpails MIKCr1111F KWM U.S.; <br /> a te.Trarspe W AdmowWg wet of Rtotipl of MOM$ <br /> Traruporler 1 Pdntad/lypod Name sguwm ml 0 <br /> T 2 yped Name $�r�m ti ,r- - r <br /> 17.Dilmipaxy r <br /> I Ia Disampm lmkWJon Space ❑Qwrety ❑Tyl. ❑Residue ❑Pa ileal Re�Ctior1 ❑wp Re)edlon <br /> 1,t�iicct Refa�rca Marker. <br /> 17b,Alkrtlfl B F9CIly(of GerlOrator) U.S.EPA ID Number <br /> sZ Fadys Phone: <br /> tAmth Day Year. <br /> 17c.Sigr*m of Abmele FoUlky(or Gow*t) ,IANFE fill FI <br /> z <br /> JUN 0 4 2018 <br /> !'u <br /> 18.DeSgnakd Faraity Omer or Operator:Col awn of rww of meimiels cjmmdkftjww exrxpl as n Iles 17e �„yr Doty Year <br /> Prl7ler!'T}ped Name SlgnNre <br /> 169-BSC-0 6 10498(acv.eros) DESIGNATED FACILITY TO GENERATOR <br />