Laserfiche WebLink
NON-HAZARDOUS 1 Generators US EPA ID No 2 Page 1 3 Document Number <br /> Of WASTE MANIFEST 1 NH- ; 45438 <br /> 4 Generator's Name and Mailing Address <br /> LI <br /> r_ <br /> 4 �l <br /> Generat#or's Pho41�x- <br /> 5 Transporter Company Name 6 US EPA ID Number 7 Transporter Phone <br /> 4 <br /> I <br /> CLEARWATER ENVIRONMENTAL CAR000007013 (510) 797-8511 <br /> 8 Designated Facility Name and Site Address 9 US EPA ID Number 10 Facility's Phone <br /> ALVISO INDEPENDENT OIL <br /> 5002 ARCHER STREET <br /> G ALVISO, CA 95002 CAL000161743 (510) 797-8511 <br /> E 11 Waste Shipping ppmg Name and Descnpt�on i2 Containers 13 74 <br /> Total Unit <br /> E No <br /> Type <br /> Quanta WWoI <br /> R a <br /> T Non-Hazardous waste, liquid rJ fi <br /> G 001 TT G <br /> R b <br /> 15 Special Handling Instructions and Additional Information Handling Codes for Wastes Listed Above <br /> r Wear PPE 11a 11b <br /> l Emergency Contact <br /> (510) 797-8511 <br /> Attn Kirk Hayward <br /> 16 GENERATOR'S CERTIFICATION I certify the materials described above on this manifest are not subject to state or federal regulations for reporting proper disposal of Hazardous Waste <br /> Printedrryped Name II� r Signature <br /> Ar`R ^t�r�t a:r 5 t l S' L P. ^^1r Jug , M�th Y f <br /> N j^ <br /> S 17 Transporter Acknowledgement of Receipt of Materials <br /> P Printed/Typed Name Signature <br /> E °�A ( ��F -~ `f'; �f Monti? Dao- Year <br /> 18 Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L <br /> a t <br /> ra <br /> 19 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted In Item t8 <br /> Printed/Typed Name Signature <br /> r Month Day Year <br /> r <br /> s� <br /> N Y d <br /> I, <br /> WHITE—ORIGINAL(Return to Generator) YELLOW—TSDF(Retain Copy) PINK—TRANSPORTER COPY GOLDENROD—GENERATOR'S COPY; <br /> f <br />