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fl NONHAZARDOUS 1.Genorotor l0 Numbs. <br /> T2NO 1 of3.EmergencyFlospense Phone 4.1'losle Trecking Numbor <br /> 1'/[1STE61ANIP@ST gM-.6�p__ <br /> 5.Gsnaralor's Nams and hearing Address Generator's Bile Address(A diterent than ma;9ng eddress) <br /> PG&E fv1A!'JIFF_STS -%—Z�vPC) BOX 70-10 <br /> SAN F=Rh.fJCISCO, CA 1120 <br /> _CA1161eIG'•4'PrfOtiQ.-' ____-- _ - _ - - -- _ _ _______ ---__- _-_I� <br /> 6.Transpolar 1 Company Name U.S.EPA ID Number ), <br /> PHILIP VdEST INDUSTRIAL SERVICES CAR000-177:527 - <br /> 7.Transporter 2 Company llerpe U.S.EPA ID Numbar <br /> 8.0 s'pnelsd Faolly Name and Slo Address U.S.EPA ID Nunbar <br /> SEAPORT ENVIRONMENTAL CAL300032058 <br /> c 7e,'• SEAPORT DOULEVARD <br /> I,FC1�V0CID CITY, CA 940,63 <br /> --_-- <br /> - 1e,CoMakwrs 11.Total M Lhl <br /> 9.Waste Shlppng Namo and Dew%n No. Type, warmly, VANoI. <br /> cc NON HAZARDOUS WATER - 001 TT G ---- --- <br /> i <br /> 0 d k�� <br /> w z <br /> ( 0 <br /> 3 - _- - -- NOU302018 - - _- <br /> I <br /> 4. ENVIRONMENTAL HEALTH <br /> DEPARTMENT _ <br /> 13.Spedal Hmdd!-ng Inslitrctbns and Addl'o/nal Worrmallon <br /> / 'j V/� 1 <br /> �19✓.r. ow r J--Ln ey <br /> z v <br /> 14.GENERATOR'SIOFFEROR'S CERTIFICATIDN:I hereby declare,that the c.!.Is of ills toegraaod 11141o'4y aea11K`lulata`y drL'flrcll alum try If*pUF-0r flti Vag name,and ere dassIf6d,packaged, it, <br /> walked and IsbelMlpaoarded,and are Irl el respeds In proper condGon for transport ts:w aig to apl4:ab!e klMrwl'wh•a i mlimi gmawamal r(pia';ons. <br /> G n•)r+rai:'filll•ru:'a Prinlo&TypadNaprr ,t= ;�[ Sgnalure I!anlh Day Year <br /> J ' V f'i [1✓ /ry�_' <br /> 15.IrAtmatlonal Stdpnierds to U.S. ❑apon from U.S. 1 Pal/ of er g1*)dC <br /> i cc IB.Tritamife}Acknvafedgmenl of Receipt of fAalerials <br /> W, 11.1 rear 1 P1 •rJ Ia1or Sipnalur9 Month Day Year <br /> Transpolar 2 Piuvedfr poi Name Shjnelwo hnrlh Day Year i <br /> 17.Discrepancy <br /> 17a.Dscrep3rlry IntRatisn Spate ❑ By ❑Type ❑Redd,, ❑Panw N,,.Lw ❑Ful Rejector ! <br /> __ f._1gr.':_rs_I_R_a_larerv�lwmber. ' <br /> 17b.Alternate Paca,ty(or Ganaraloo U.S.EPA ID Number <br /> 7 , <br /> U <br /> L.( Padirys Phone: _ �, ---- — <br /> 17c.E na ire of AlIamale 6ci ity(or Generator) lk+�t Day Year 1! <br /> r <br /> 1. <br /> n <br /> O <br /> 18. •✓pkd Facifty onner or 0peralor.CtO4atm d rice pl of mafadats covered by the menifesl except as rWod In Item l7a _ <br /> V"dv;yl:ml flame - — B'.gneture — I!n h Day Year <br /> DESIGNMEO FACILITY TO GENERMOR <br /> 109- ,_C-0 5 11977(Rev.9109) <br />