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<br /> �It ♦ UNIFORM HA7ARDOUS 1. Generator ID Number R ' " ° ^ •r' 2. Paget of tf. Emeigerrcy Resyyonse Phone 4. Manifest Tfacking Number 4; : O , 3 ;- ) OF J
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<br /> ' y 5. Generelots Name and Mailing Address • 7 Generatbes'SileAddress (if different than mailirig•address) r. . ,sk as .y .f• rrr',` ' A ' ) , , ,
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<br /> COMPTON CA 90221 '' , ` r COMPrON r r , , Cil " 90221
<br /> 310 886.3400IF
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<br /> 6. Transporters Company Name • _ f U.S. EPA ID Number ► r '
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<br /> 7. Transporter 2 Company Name „ U.S. EP1t1Airr�b5 017 5i4 2 2 ' • '
<br /> WORLDWIDE RECOVERY SYSTEM INC • t • . G A
<br /> 8. Designated Faci ity Name and Site Address U.S. EPA7D Number
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<br /> EMERGENCY CONTACT : CHEMTREC 1.800.4249300 ' .* PROFILE 0 9BI : 081916. , 9B2 ; 081916 • * APPROPRIATE PERSONAL' :• ..t ' .i
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<br /> ' FFEROR'S CE FiCATION: I hereby declare that the contents of this consignment are fully and acaratdy described ebovA by the proper shipping name, and are classified, packaged,,; , 1 t;,;
<br /> " marked and lebeletl/piacarded, mid ere in all respects n proper condition for transport according to applicable intern net and national govemmental regulations. If export sft7prnent and I am the Primary . 'fit
<br /> Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAdmowledgmenj of Consent = oiia
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<br /> I ce"tjiry•that the, waste mintmollon statement identified m 40 CFR 262.27 a (rf I em a la a uan(ity generator or I em a small uan ' eneretor is sore. .
<br /> Generetorsl0ffererePri letifrypedNapre Signature ' Month Da ; Year , s
<br /> F 16: International Shipments Import to U.S. '.0 Export from U.S. Port of entrylexit ' ' '
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<br /> V�LL1 .a 17. TrenspoderAdmovAedgmentofReceiptofMatedals t ' ' : t, 4 IF
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<br /> EPA Form 870 •2 (Rev,. 3.05) Pfevious •editicnsareobsolete. ' '40 011 't "' D SiGf ED FACIL' ITYTO GENERATOR STATE �IF FIEQUIRED) to t'z7
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