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NON-IiA7.ARDOOS I.Gonora!a ID Numbar 2.Page t of S Emergaicy Responsa Phenn 4.WuEe Traoldng tpmrber <br /> WASTE I11ArAFEST CAC1]02957105 1 650.331.8013 NH18061009- <br /> 5.Gemraben Nurse and MON Aftw -- -- —-- Cwender's she Address(d dOcard Mien mWV oddress) <br /> SUAffitHIL1 APARTMENT COMMUMMES, 1009 ROLUNS ROAD <br /> 30x0 BMDJTIVE PARKWAY,SLATE 450 �,CA 94010 <br /> SAN RAMM.CA 94683 <br /> C-eneraM RM - 415-994-1307 <br /> - <br /> 6.Tronepartor t ComQorry Name U.S.EPA ID Number <br /> 7.Tw"or*2 Company Name U.S.EPA ID Number <br /> 1. "t �+� U.S.EPA ID Nornber <br /> S1A&VcA nF 58HLLS 5 LAKE <br /> 707-4324WF a Phone: <br /> 10.Cameinero ti.TOM 12 lkm <br /> B,Waste S�*5 Name and Deecripdon <br /> No. Typo Duarday WtIVd, <br /> 1. O Wiii TE DOUS SOIL) 1 DT 18 'Y <br /> �a <br /> 2. <br /> 1e <br /> 3. <br /> 4. <br /> 19.Sp1s CWPar� ��Ons and Addl"W kdonnnlat <br /> ULL M CATALYST EWIRM&NTAL <br /> 14.GMERATCR'PJOFRlM S CERTIFICATiOI@ I hereby ftbre brat the cw"ba of am coral?nerk are luiy And amoral*described above by the p Ww sAlp%name,mrd are das*M,pa*od, <br /> maftd and WbeledVacarded,and are m el reepacta m proper Mdoon lar b&,Wft acwmtM b sppbcebb atlrr MbW and rarbtatl atlona <br /> G W ftM(& tkrladl7•yped Nnme aiynelure • Non1h Dsy Year <br /> 15 hlarabnd ❑lmpod to U.S, 0 Eapa1 from U.S. Pat of entryleodt <br /> T"porter S"n lun fforegaft Deb bmft U.S.: <br /> cc 18 Tints>orlar Ack mWgrnent of R"V of Ms*Ws <br /> Tra wpmler 1 PrkswYtMd Nems algahne Mormr Day Ytp► <br /> \ L/ (U <br /> TranWrW2 Pd ypad Nemo ftnit" Month Yeu <br /> 17 D*Mpam <br /> 17a.axrepancy Ir"on Spur ❑ ❑Type ❑Residue ❑Pam&I'ton ❑Fu1 RaW. <br /> Flanks Refew=Number. <br /> 17a Ahamab Fadby(or 68=200 U.S.EPA ID Number <br /> a. F.cW$Phone: <br /> 17c.SWAn of Abmeb Fa$ky(or Ganer*r) Month Day Year <br /> 0 <br /> 18.Dasignelod a t7paralor:Car6�ddbn of ttcefpl d melarkria covered by the ta�ileat escept as rpbd m rlerrr 17a <br /> Prhtedrfyped Month <br /> 169-BLC-O 6 10498( 9/09) DESIGNATED FACILrry 'O GENERATOR <br />