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<br />, UNIFORM HAZARDOUS
<br />WASTE MANIFEST
<br />II' Gen8111111ID flu2lber CACCO311114364
<br />Page 1 of
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<br />&Emergency ReSpOi193 Phone
<br />8774564265
<br />1,....=U11312. WO rm. ZU3U4A4121
<br />4.5i:oldest
<br />0211b0751 JJK . ..tlentratee'eStAddrasi (ff different than marling address) GerfOrt ilddreas 1114 UtERVes Widen . . . • . eA -r.: 1.. . . • . . *( . . . Generator's Phone: 20.9374700 • .. .• .„•,. •
<br />. u.s..ffaaniumbr4 ; •. . .. . Poitdci Etaftnirattri Sly/lois' ''' ••• - . ; • - 1 'CAtilo0011i1075.r.. Transporter 2 Company Name U.S. EPA ID Numter ' . I .
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<br />... .. - ...;;.t. Name pod Site Address U.S. EPA ID Nurribes ' 1,.. • Of I A Regal .i..4., . / .
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<br />'W r, 2000 N. Wrack • . •
<br />Ovnittan, CA 0024 • . , • . •
<br />•310437-7100 • CAT08001 33'Sr •
<br />ell. U.S. DOT,Deicit4(frt4ding Proper Eliipping Nimejlazardtliii:IDNiimber, „,,v., to. boradnera it Total 12. Unit' cad FaddIN ercoP1180) NO. '' ' 11• Waste cech
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<br />OENERATCREFORTERORI CERTIFICATION: thereby dedere that the coaterris ef lide omstrimen 18t8 hdly end accurate& destbed above by the proper shipping name, ani aro ciassiled, par:lewd,
<br />marked and labatedipiacarded, anidere to eil impacts In Fever *am ter tramped accodIng tolirptable International end Mired screernmented widens. U owl stand I arn the Primary - i -.z - Exporter, I sadly that the andante of Vs consIgruneat conform to the tams of lite attached EPA Acipoidackmartt of Consent. • I certify that III8 - . "...La. ... 4.. statement !defied In 40 CFR 28227(a) RI am Marge . .41 r,i,„54...: !... . (b) (if kri. a sinail ..... .,... geneartorps true,•
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<br />4Ttou.s. 0 Exrkat from U.S. Redid enby ...i. .. — Tres:gates striatum Oar cate onty ' ' ''"' Date tearing
<br />il 17. Tonsporter Aciatoniedgmanififeceiptof &latest'. .0 „
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<br />172 " / ' '? il ''.6F/ . • ..// '1, LI 7— ". - -*•-• '' - •
<br />' 'Taut/porter 2 PrttecirlYpad MUM .:.' • ' ' i Day Year -..•,. ' , „ I I 18. Discrapancy - -. .. • ._ 1.
<br />18a. Discrepancy indlcatien
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<br />Residue Rejection . , 0 EtaRalecf#,..... ..4. i
<br />Reference Number .
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<br />Mb. Attenuate Fedifly (or
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<br />U.S. EPA ID New . •
<br />-:. . • ' • is or • i•,) — ... FrialitMin • v • ' 0 18,n, Slanatum °Warn& Factity (or Gerterater) " , Mont Day
<br />19. Hamfdoils Waite Roiled kmanement Method Codes Os., axles for haiterdous WaS53 freentea disposal, and resyding Systems)
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<br />20. Dedgnated Peaty OW= or Opdpgon Cart5sation of receipt of hassudeua materials covered by the manifest =apt as tn Iteroge •
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