Laserfiche WebLink
Stole of CvliFamia-Emiranmen�hobclion Agency <br /> Form Approved OAP No. O00391Expires 9-30-991 See IestFYCflons on back of --go 6. Department of Toxic Substances Cone <br /> Heaseprmtartype. Farm�asigned For use o,elift(11-pikh)f iter. Sacramento,California <br /> UNIFORM HAZARDOUS 1. nerabls US EPA ID No. Manifest Document No. 2. Page 1 Information in the sImd*4.reas <br /> is not required by Federal law. <br /> WASTE MANIFEST rj 7 of <br /> 3. Generator's Name and Mailhg Address <br /> U.S. RENTALS --- <br /> n <br /> n A. G2081ERons(CHARTF�R WAY. STOCKTON F CA 95205 ro Gen...ra;t ID - , <br /> enerator's P . .. <br /> N 3. Transporter 1 Company Name 6. US EPA ID Number ,7mnsporter's ID <br /> h <br /> m y_ <br /> C sporftr's Phone <br /> O <br /> tD 7. mmpoMr 2 ompany Name 8. S A Num6ec Transporftr'z ID <br /> 5Y <br /> Q :�Tlanspodm'z Phone <br /> V 9. Designated Facility Name and Sift Address 10. US EPA ID Number G. State facility's ID <br /> CHMICAL WASTE MANAGEMENT, INC. H. f«I IPhone <br /> 35251 OLD SKYLINE ROAD, KETTLEMAN CITY CA 93239 7o,e.. <br /> 72. Containers 13. Total IA. Una <br /> L�a 17. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No T Quantity Wt/Vol I. Waste Number <br /> oc Z o. Sroft <br /> 1� NON—RCRA IIAZARrOUS WASTE SOLID99, <br /> G (OILY SOLIDS) NAERC963171 EPA/Other <br /> o N b' Scft <br /> m E <br /> R EPA <br /> /Other <br /> Q A c to <br /> o T <br /> a0o O <br /> R Other <br /> s _.. <br /> d. <br /> Z <br /> w <br /> V /Other <br /> w <br /> lion al 1 For Myler <br /> 2 al ti s� <br /> N <br /> W i <br /> fY <br /> Q <br /> 0 75. Special Handling Instructions and Additional Information v <br /> Z <br /> HANDLERS *E 40 HOUR OSHA/SARA TRAINED <br /> = AND USE NIOSH APPROVED PPE. <br /> EMMUNNey MIMUM (916) 171-57&7 <br /> j 16. GENERATOR'S CERTIFICATION: Ihereby declare that the contents of this consignment arefully and accuraftly described above by proper shipping name and are classified,packed, <br /> IIIQJJJ marked,and labeled,and are in all respects in proper condition for nomport by highway according 10 applica6le international and nationaPgovernment regulations. <br /> If I am a large quantity generator,I codify that I have a pro ram in place to reduce the volume and toxicity of waste generated to the degree I have determined to be monomie 11r <br /> a practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human heolth <br /> and the environment;OR,if I am o small quantity generator,I have made a good faith effort to minimize my waste generation and select the bast waste management method that is <br /> Oavailable to me and that I can afford. <br /> } Printed/Typed Noma Sign Nra Month Day Year <br /> I Z / O <br /> w 1 17. Tram r 1 Acknowl mento Ricei t of Maftrials - <br /> Prinftd/Typed Nome Signature Month Day Year <br /> W f _._ .`�_ ��" __ 7 <br /> W 78. Trona reiptof Mot 1, <br /> O <br /> E <br /> R Printed/Typed Nome Signature Month Day year <br /> N <br /> EEE QQ R <br /> fF 19. Discrepancy Indication Space <br /> ' — A <br /> C <br /> ' I <br /> L <br /> I1 20. FacilityOwner or Operator[edification of recei t of hazardous materials mwrad by this manifest axn 1 m noted in Item 19. <br /> T Printel/Typed Name Signature Month Day Year <br /> Y <br /> j DO NOT WRITE BELOW THIS LINE. <br /> I` DISC 8022A lA/971 Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br />