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FROhI : AMERICAN VALLEY INC PHONE CIO. 215 6661 '61E0 . Oct.. 15 2001 01:21F'M P2 <br />Slat. of CoLforniv—En.ironmanral Fttgqls�ytlgn,pgen<y See Inst�uetioris on back.of pagtl 6. arpn me, Ta'i: Saatwne9' Cam :I <br />farm Approved OMB No 2050.003Y10fpi=se 9•"50-991 - _ $aa c 9ma, Cchfarn a <br />'Hw+i pnm or HPe' Form dalgnadi .Ui�oh, eiin (12•pdehl Ap4wri'r - - <br />F' <br />i <br />DTSC 6022A 11/99) <br />EPA 9700-22 <br />150 Rf7E 6�I,Q.'�NE. <br />Greer. 7n.. i,-.., ;ETAIN$ <br />—___---- ...,,yo <br />UNIFORM HAZAR60US Genafo t o o a"i°' d! a ad'dy Peaervi ow. <br />WASTE MANIFEST I �I 'I oil <br />3 Generator's Name and Moiling Addreu A $!01914anife,l Docv.96A! Numbor <br />; 21142747 <br />`Slat <br />Vc�,rslf � <br />\ ?5(� ' r l) l neK V hr,v B nolo ae l lD <br />A. G ...... !or', Phgn9 {/Q�1' ..,,.J� 'tn f' rt � i�')7 I ..: <br />S. L•vaeparlrr 1 Company 6. U$ EPA ID Ne.n er �-� <br />C. $: a 1 an)porler'a ID (R <br />. <br />MEifCAN VALLEY WASTE OIL 1 2 7 1$ (8 <br />DT n Pcrtar:s Phone 6t)(1 Y".', 4(i s i <br />7. Tramperter 2 Company Name 8.. US EPA ID Numbor i <br />E: SIU Tromperter4 ID <br />irampod4P9 Phone <br />r b and Sita Add u, 10. US EPA ID Namber <br />G. $ta <br />f, t iry' ID " <br />I� '0 91a :2 I'3 5 8 <br />430 ALMOND ORF <br />i Ea I,yt Phone :. <br />nvFRSPRINGS, NV 89429 ') ala A fA <br />7(1_7.-677.9001 <br />11. U$ DOT Deterlplien Ilnduding Proper Skipping Name; Xoza•d C1mt, and ID Numborl' t <br />12. Ceniolner, <br />1. 13. Talar <br />1 Ty a j - Ouantily <br />a. Unit <br />•WI/\'ol <br />f_- <br />I. Wavle Numbor , <br />No. <br />a NGIN• PRA HAZARDOUS WA$Ts pgUfq <br />S:a!P �?,I <br />EPA/Othar <br />(OILY WATER)I' <br />T T <br />G. <br />) <br />y <br />smtr <br />N <br />Eva/Olh.r <br />R <br />I I I <br />REPA/Otho, <br />�• <br />�� <br />d. <br />�I� <br />$rale <br />I <br />II 1 <br />EPA/Omar <br />J Addibgnd lAt91 1fgA Or'vh Litttl Aktov 1 ar '"' \Y� i:• <br />]i 1 1 �' 9 r r i. t�!1n�"i�i <br />K H n g Coq l for Wave, <br />,eJ Abovv I <br />y+1 �(ti�F"!1 N1J�✓* r"y1 (iA'N, t J 'V 1�) /y �.%'�r��1VfiY: ', <br />y�qW^�AY�F I'IrS�•`I�/h I�)Yl��i <br />�.,tx <br />1�1' \ <br />�7 <br />I <br />d <br />�1,y\e t5 f�� �•. i � <br />Ir�.A <br />f4. <br />. <br />A a,yy <br />t 4I r.'r)� <br />15 Sputol Handling InNruc(ons and Adddional'lnfarmulion <br />GLOVe8 y <br />EMERGE NGY PHONE 209-W (4057 . <br />16.-0ENEIATOR'S CERTIFICATIONI I hereby deeJari rhes lho< n'onit pfthii ccr4 moor oro fully and accurbhlyy'described above <br />in proper ce . gprOper s{•.ipPirg name and oradmsdd p •+ed. <br />iatlo vv and nolionat government ,agora :cr: <br />Irampprt by highway ading to apt, kct'ola nbrn <br />marked; and lo6eled; and or. In all rnpscL ,tion for war <br />111 am a large gdanlily generates, I Comfy that I haw a proyam in place to reduto the vo ame and t9.0y of wade genera Dd la the &4e, I ha,o dawrni :a d .o our ,n�„micvl:y <br />or ditpotot currently a 61.1,1. !o me whiih i mml9y the protent and finer. 'hreat m r man health <br />pra<ticabh and than hhaw uleeted the praetieob)e method a traatmenl ;toroge; <br />and the enviranmenl; OR, if I am a Dmoll q.mly fl.w. w, I hose mode o good faith oda ! to minimize my waste generona+ and 161441 the batt ware monagomort m.mod that is <br />avoilobA to me and lhO I can afford. - <br />n <br />Phi Q) G�--1 ��eYA TV 9— Month Df:y Year <br />hinted/Typed Nome . �, A.1 eor (% G e+IV� a 1 re. ^— ' ' .. ' <br />' <br />r '^ <br />rt <br />1 <br />1 tens ortsr.l <knowle amen aF Recsi ofMoteria_ <br />— <br />F <br />$ignowre <br />;Aon!h Dcy /oar I <br />Y <br />Pr' ted/ 9 If ame <br />i <br />�lt <br />1 r 1 Ot16r 2 Ackngw emont of R.,, 1 of Mo .6.4-77 <br />Mdat:, you <br />1 <br />hinted/Typed Name <br />Stgndtme <br />-- — — — - <br />19. Diwnpon<y !ndlegl;en Spoee — <br />C <br />'f <br />1 20. Facili Ow ar or O eralor Graf cation q{ re44i r of to . d a orerioh <br />cover I it m "'f'.! snc.of at n044 in Itom 19. _ <br />T <br />Print../Typed Nome <br />y Year <br />DTSC 6022A 11/99) <br />EPA 9700-22 <br />150 Rf7E 6�I,Q.'�NE. <br />Greer. 7n.. i,-.., ;ETAIN$ <br />