Laserfiche WebLink
-+ eed'eesl. unifo= A.I'a'zFU <br />UNIFORM HAZARDOUS <br />1. Ganemtw ID Nwober <br />eU$H <br />`dU55D <br />2ul'12 / <br />T.�n e. 7pRS'ITO <br />Route. <br />WASTE MANIFEST <br />ILR000130062 <br />+i'''5; <br />2'IF!ADmoved. OMS NP.39 <br />600-424_8300, .,3 <br />Pt863ephnCOrtype. <br />UNIFORM HAZARDOUS <br />1. Ganemtw ID Nwober <br />2. P11. l of <br />3.EmwAmry Response Phom <br />0.M <br />nll}}.s,tiJac <br />U O <br />T� <br />°C,� ryr�pp GBF <br />d G 4 <br />WASTE MANIFEST <br />ILR000130062 <br />1 <br />600-424_8300, .,3 <br />.� <br />eiI'mpqddre Genewara am Addmn ka columna Nan maltsgadmass) <br />S. GanembfsNamm rd MLLC Heritage -Crystal Clean, LLC <br />mLLC <br />2175 Point Blvd, Sult'eft 375 4370 Absolut Avenue <br />Elgin, IL 60123 - 877.938.7948 Fresno, CA 93725 <br />Ga.&tr Phore: US.EPAIDNombe, <br />6. Transpwler i Comp "Name <br />HERSTAGE-CRYSTAIj CbEAN, LL(,' S G <br />7.T.,mr2Comp.YNarm - U.S.EPA IO Nwder <br />B.OeNgrebd Fauliry Name ard BBe PdNeas U.S. EPAIO Nwrbar <br />HERITAGE ENVIR0I4111SWTAL SERVICES, LLC A E 55 0 8 1 7 0 4 4' <br />204 E STOREY RD <br />o00LLIDGE, AZ 65128 {820 723-4167 <br />Po <br />9a. <br />9b. LLS DO7DesdPfim@duAng Pmpw SM1ippap Nmm, Namd CMss, ID Nwrbw, <br />18. Conhinwa <br />it. Tghl <br />12. UNI <br />13. Waste Cavies <br />No. <br />Type <br />HM <br />.MPadk,G.,lNny)) <br />DDanIOy <br />WLNd. <br />NON-DOTIRCRA REGULATED, (AQUEOUS PARTS CLEANER) <br />DM <br />G <br />221 <br />I liJ <br />z <br />z <br />w <br />cD <br />3. <br />a. <br />14. spodal HerAlNg lnswGlDnsaMAtltliOonal Nfommlion <br />9b.1) TSD 213184 9b.3) <br />J <br />9b.2) - 9b.4) <br />15. GENERATOR'6R)fFEROR'SCERTIFICATION: Iherebydedare Nat NamntmNolNMmMlgmmnl are MfiyaM amaabty desdbed abgre 6y BregopardippNA rame,eN ere dassifieq paaNageq <br />marMatl eM rabebNpUmrtld, and era h a0 reepeNs In proper mndi0m far hansPod eocatl6g m eppfimbb InbmeOmN and mfimel Awemmm W mgWalMs. II exlsod sNpmml and I em Ne PrMary <br />&pwbAlceAfy Nal Nm mNenls olttdsmnsiAmmntamlarmbNelemxdme efMtlied EPAMS mNedOmant of Consent <br />osNfy Nat Ne v2ala miNm'vatbn s ztement kendfetl In 90 CFR 2629(a) g l am a large W melt' generabd w @I (N em a mna8 qum0ly ganemlwl is we. . <br />G .aamVOflem(s PdnleNyped Name Slgnabre ^ Monty Day Year <br />RuseN Yin. G E 0 pS as ao <br />16. wemaocxae Wspmum ❑brpadw U.s. ❑Evodtoou.S. Po4dmhyledt <br />T.Nnar signature (w ap rtz mly): Data l..q. LLS.: , <br />W <br />17. Tmnaponsrnam Wgmanl d Ramat of Mabdala <br />MaNh OeY Year <br />Trenspoder 1 PMled'ryped Nam° Slgmhae <br />a <br />u C -N tM. - <br />z <br />TmrspgRw2PdnMMYPed Name 89naNre .n. OaY roar <br />18.0aepar , <br />Y~ <br />110a. <br />Diawepanry ln.Wn Spam E] .,y ❑TyPo ❑ResMm ❑PaNal Relecc-n El Far Re)edon <br />Wmf.,t Referenm Number. <br />i86.AINmate Fadily (w Gemrebd U.S.EPAIDNumber <br />rai <br />Farlty, Phone: <br />Monty Day Year <br />w 10c. Gigmbre ofNlemale Fatltity(w Germrebr) <br />2 <br />y1A. Harallous Waste RelaM Managemml Melhotl Catles@e., mdeslwheraNmswaslelreaMaN, tllsposal,ardrecyduq syslenul <br />2. 3. <br /><. <br />28.Oasigmtetl Faallity Ormeror Operator. CeNlh Aon olrecelDtMhaaardwe malmials arrered by lFsmaNlesl accept asntled hlNrn lOa <br />I PMIeNlypetl Nama SIOmIwe Month Day Year <br />EPAFarm8700-22(Rev.12-17) Previous editors are obsolete. <br />nrClrMnlxn erre "Tn G9llra,-PAAMr6CU" avCTFcn <br />