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SbN al Calife;..'" fon sal Prolsctfon P 1 �• <br /> _ Foyp Appoved OMB 39(Espim,f 09) - See Instructions e,.oack of page 6. Department of Tosom S.ban <br /> Please print or Ijfpe.-Fens d.,ienad for use on elite -pikhl A mvrifer: Sa mmeato,Calif <br /> y . <br /> - UNIFORM HAZARDOUS - f. Ge"eraloes 05 EPA - Manifest Document No. 2. Pape 1 1.6.h.in 16 shaded of <br /> WASTE MANIFEST is na rogai ed by Federal k <br /> a O 1 0 6 6 5 4 7 6 °f 1 <br /> - 3. CDnerdb/s Nomeaid Moiling Address - <br /> GEWEKP. DODGE <br /> 1255 SOUTA BECIMq VAD' W F <br /> LODI, CA 95240 <br /> V n 4. Garroters Phone 120 ) 327-0010 ' r <br /> j S. Tromp ster 1 Company Name 6. US EPA ID Number Y <br /> o MHOS ENVIROhWeXTAL SERVICES <br /> sD A.Tramporter 2 Company No. 8. US EPA ID Number <br /> 9. Designated Facility Name and Site Address 10. U$EPA ID Number �, t <br /> Z PACIFIC RESOURCE RECOVERY <br /> qr <br /> 3150 EAST PICO BLVD, 4 0 5 <br /> �0 LOS ANGELES, CA 90023P W ID IS ID <br /> .%- <br /> 11. U$DOT Description lindedirg Proper Shipping Name,Ila:ard Class,aed 9)Numbr12. Containers 13. Total 14. Unit <br /> No Type Quantity Wt/Vol r <br /> NzFE -WAOk CO16USTIRLE LIQITID,N.O.S.vRA1993,III n' <br /> 3 G (oil, 11111,Trichioroethans) TRG '00 4128. <br /> E <br /> m E <br /> v it <br /> R r <br /> F d <br /> W <br /> IJ <br /> W <br /> Qcl <br /> asd <br /> Z 15 Special Hling Imtrvctions and Additional Information <br /> O FSANDLERS TO BE TRAINED AND USE PPE. <br /> i 24HR EMERGENCY C011TACTT 916-371-5747 <br /> W <br /> 2 WEST LOCKEFORD STREET, LODI. CA 95240 <br /> 16. GENERATOR'S CERTIMATION: I hereby dedam that the contenh of this consignment are fully and xcumt r described above by proem shipping name and aro classified,pocked <br /> Vmarked,and labeled,and are in all respe in proper condition for transport by highway according to applicable international and national government regulations. <br /> -Js If I am a ho anti tor,I."i that I have a <br /> rge qu ry genera fy program in place to reduce the volume and baidt f waste generated to the deg 1 have determined to be cconom <br /> Hpracticable and tlol I have selected Bre practicable method of treatment,storage,or disposal currently avaih61.to me which minimizes the present and future throat w human h <br /> and the enviromen <br /> nt,OR,if I am a..If quantity generator,1 have made a good failh effort so minimize my waste generation and select the best waste management method d <br /> O available to...ad that Icon aBad. -„ <br /> r PriNed/T ed No <br /> mg .�, s t SipnoNn - MarIL pay <br /> C L ,( ��7 ! t <br /> Z y ,t'!1 ry Y i& 'j'• /,/" } �t,.. �. '"�.!r;'C`` ��< t.J •+� <br /> W T 17. Tmm' V t Ackrowle ement of Real of MaMihds -- <br /> W R <br /> Printed Ngme Signature Mond .Day <br /> W P <br /> LL P 18. Trasnaparlar2A&mn Material. <br /> O T Pri.W/Typsd Nam.- Signessrdr MonBr Day <br /> W L <br /> � E <br /> V19. Discrepcnry Indication Space <br /> Z F <br /> A <br /> C <br /> I <br /> L <br /> ( 1 20. Focilily Ow a Operm4or Certificnfion of mostipf of hasardo s materials coverseliT This masifesl sanowt as now in Rem 19. <br /> T Prinbd/T Nome O Signature Monti Day <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A(1/991 <br /> EPA 8700-22 Green: TRANSPORTER RET) <br />