Laserfiche WebLink
Please prinl gr type ( FGrm Eesignetl for use on atlte ( 12-plkM1 ) pervnhrJ IIIIIIIII � IIIIIIiIIIILII I III II Fmm Approved . OMB Na . 2054003§ <br /> UNIFORM HALIRGOU3 IGeruralwlG xumber xPe9e for ± Emergency Resppns one anr012121190 FLE <br /> WASTE MANIFEST CRL0004 'c`7514 1 877577c' 663a Pn <br /> 5 . GenerelNa Name antl Maaing Atldreaa Genenkfs .Gu maiyatltlress) <br /> Rath & Bady Warks ES ss Bath m & Body Works # 65 <br /> 2099524396 5304 PACIFIC flVE , SHERW@CD MRLL / SPACE 6 5308 PACIFIC RVE <br /> cam : amr 'aanona : BT@CKTCN , CA 95207 STOC &TON , CR 95207 <br /> ransponerlCmmpany Name GS EPAIO Numlw <br /> Steric cle 5 ialt Watt ? Su Lit ions Inc MNG0001109 ^c4 <br /> r wme• zemn ame oT us . EPA 10 Npm5 � <br /> 1m <br /> e . Gesmnaled Farilln rvame and sl ;eAadreea 27 st Cerlt ury EMN , LLC us . EaA lG xammr <br /> 2095 Newlands Dr . East <br /> Fernley , NV 89408 <br /> FarilAya Pmne :7755752750 NVD9B0835338 <br /> sa , sb Gs . 00T oeep ; popn unnw 'ay Propersnropm9 rvama . xa :emclaa; . lG Nerrcer, Ig . crenMnera nmol 1z . unX lanvaam cpeaa <br /> NM and Pxtlirm Gaup (RanYl Np tYpe puanlih N11Na <br /> ase amnia a zqui s , : n . o . s . ( E hyl 1 CF 00@32 P 331 ' ID001 X1002 <br /> RlcohGl , Rcet Gnei , 3 , PG II , ERG # 128 I <br /> ' as a erase 5 , anima le , ( each not 1 CF 0@00B P 331 � ➢ @01 <br /> exceeding 1 L capacity ) ] 2 . it ERG# 125 i - - <br /> 3 . <br /> 4 <br /> 1e . spmial NarwXag mamanpne anenaampna lmamraXpn 1 . 1109@5 ( Flammable Liquids ? 2 . 1109@4 ( Aerosols , Flamma61 e1 <br /> 15 . GENERATGR 'SIoFFERoft ' GCERTIFNATIGN : IM1erehy deekre lnaltlremmenm plmiemnaignmenlare lolly antl amumlely � sza5edabwaby lne prppersinpping name . aM as [ uaslfiea paFaged <br /> meMetlard labeledmlaardetl . antl arern all respaGs m prppermndilion la Iraespan a ¢, reing b appligbk inlematipnN aM nelbnel parmmmenlal regaalmns. lerpprlshrpmentaMl em me Pmnery <br /> Exawur, l mrtily Ina ( lne mnunls aXwh mnsgrmrenl mnmrm u me lemw oMnealumea EPAAcknovretl9menl of Cpneenl . <br /> I axlhmel merasu mmlmlzelWn slelemenlla ¢ ntlfiea in 40 GFRxBxRr (a ) lfl amemlgaguanury gemawl or bl m l am a small WenlTygeneralpR6vee . <br /> Ganamm mgaran PnnlMRype Name " m ' am Alf of Limit § av <br /> r ' r�ly r 1 .kGr— 10 10 @IB <br /> � 1e . mcemanpnal snipmmla ❑ Imppnmus . <br /> ❑ Expankcm u . G . Ppx ofenVyleHX : <br /> � innspmur sia rea (wru pm Gele leeWn U5 : <br /> nralmrlmAGrwweagmem ol � nlptNMauiyls <br /> Ta svorkrl PnnmNypetl Name gnaw ay <br /> H Isidro Martinez i@ 1@ 018 <br /> aerR PrmleWrped Nam gnmure m y <br /> I ' S Glampaary <br /> ea . olaRawnn mm ® Xm swr, • ❑ opannlY ❑ rvpa ❑ Rearepa ❑ ParualRalaxian ❑ Fwl Raiaelan <br /> MemmestRererer , m rv � mber : <br /> reb . AlMmalc Faalnh mr aaneremn us EPn lGxpmSer <br /> uaLLi ; a&uli5ignaweaNwmaeFazXlN (pr Genemlpr MmIM1 Gay Year <br /> y19 . Nazardwa Weau Repcn Managerrant Memod Lntlea ( . a . maaa (m M1amrckrrs xasu beebrent. dLswrd , andrxyMirgzysumel <br /> zo . oesgnaleo FauXry arner oropa<alor eenlaeawnelrerarrranavrcova me ;analaeor+,ed qme mamiast . , repras nmea in Ilam lea <br /> ill Fnn Rypetl Name 8ignalure <br /> y <br /> EPAFwm Sl00 -11 ( Rev. 3 -05 ) Previous eollions are ohsolem - - - <br /> 8700 - 22 12v3 GB293378 541 @F, � 815 041217547 nl 0o 101012 3 Crl0r 'r19 <br />