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p� Manifest �37�rJ�]6� 2.Page1 <br /> T-1-0 <br /> (iof�c�DU '7 �. (Document too. of <br /> BILL OF LA®IN <br /> 6411tH HARRISON ST CA 95203 <br /> STOCKTON 209 46"230 <br /> a.Generator's Phone( ) <br /> GADOS }�p/y A.State Transparter's ID ` <br /> 6. e� S.Transporfef 1 Phone <br /> 5. 5161E`�,`AftbNMENTAL SERVICESC.Stale Transparter's ID <br /> $ DS EPA ID Number <br /> 7.Transporter 2 Ccmpany Name D.Transporter 2 Phone <br /> 10. <br /> DS EPA 14 Number E.Stale Facility's ID <br /> 55375 SOUTH BOYLE AVENUE CAD 0 9 7 4 3 0 9 9 3 F(Roby2'0&7747 <br /> LOS ANGELES CA 90058 — <br /> 13. 16. <br /> 12.Containers Total L?nil <br /> No. <br /> 11.WASTE DESCRIPTION Type Quantity WLNoI. <br /> xxAA �7 <br /> _ Q M r <br /> t UN1950,AEROSOLS,2.1, ,UNIVERSAL WASTE' <br /> /50b <br /> c. <br /> Z d. <br /> H,Handling Codes for Wastes Listed Above <br /> G,Additional Descriptkons far AAaterlals Listed Above <br /> LL <br /> 15.Special Handling Instructions and Additional Information <br /> EMERGENCY CONTACT'.(;NEMfREC 1-8fl0-424-9300WOBS TERMINAL:CERES CS 'PROFILE#9B1 :627844-ROS63 <br /> FiER050t5 t P500-00115235*APPROPRIATE PPE EQUIPMENT <br /> SITE: 641 SOUTH HARRISON STREET.,STOCKTON,CA 95203 <br /> 16. GetvERATpR'S CERTSFICA710N: I hereby certify that the contents of this shipment are fully and accurately described antl are in all respects <br /> in proper condision far transport.The materials described on this manifest are not subject to federal hazardous waste regulations. <br /> Date <br /> Manfh pay Year <br /> 5ignalu <br /> Prjnted ed NamellrO <br /> Dale <br /> T '17:Transporter i Acknewiedgement of Roceipt of erials 6SOn1h pay 1Sar <br /> Signatu f t�"7 _j <br /> R �V C <br /> A Prin ypad Name l <br /> 5 S J���f /r��• Date <br /> P <br /> r3 y18.Transporter2 Acknowletlgement of Receipt of Materials Month Day `7a' <br /> R Signature <br /> Y Printedffyped Name <br /> fti <br /> R <br /> 1S.Discrepancy Indication Space <br /> A <br /> 120.Facility Owner or Operator;Certification of receipt of the waste materials covered by this manifest,exceat as noted in item 19. Date <br /> 1A011h Day h-�+ <br /> I I Signature <br /> T pdntedlTyped Name <br /> Y <br /> t— <br />