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Stbne of Coibmio—Environmental Protection Agency <br /> Yom Appiovad OMB No.2050-0039(Expires 930-99) \I— See Instructions on back os Age 6. Department of Toxic Sub.tmsces Contr. <br /> Plmse print or type. Form designed far."..lift(12-pikki ypewrift, Socramenlc,Coliform. <br /> UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 nfo motor in he shaded areas <br /> i.not raquirod by Federal law. <br /> WASTE MANIFEST of /yy� <br /> 3. Generators Nome and Mailing Address A. Slate Manifest Document Number 99719513 9 T 1 9 5 1 3 <br /> United Rentals V4 <br /> 2081 E. Charter Way, Stockton, Ca. 95205 S. sa.Gewator.ID <br /> A. Generator's Phoma( ) —9141 <br /> N 5. Transporter I Company Name 6. US EPA ID Number C. Stale Tronsporwrs ID .IRe wed.1 <br /> sn <br /> °D D. Transporters Phsms <br /> OQERVTCM <br /> C? 7. ranspo"S 2 ompany arae B. US PAI Number E. Stift TranspoHer'.ID R <br /> M- <br /> VTRQ <br /> V-4— 1 1 1 1 1 1 F. Tron.porter.Ph. <br /> Lou, 9. Designated Facility Name and Sift Address 10. US EPA ID Number G. State Focility's ID <br /> �Q D/P ENVIRONMENTAL <br /> rix 3650 EAST 26TH STREET, LOS ANGELES CA 90023 H. Facility'.Phone <br /> 1`-0 <br /> LL <br /> 0)Q PShipping NHazard ClassN <br /> I1. US DOT Description(including roper ppng ame, aza ,and ID Numb.r) o Containers 13. Total 14. Unit <br /> �() No. Type Quantity Wt/Vol I. Wmft Number <br /> Slate <br /> a NON—RCRA Hazardous Waste Solid 352 <br /> 3 G (Absorbent 6 Oil) EPA/O her NIA <br /> N E b tiAERG96o1171 state <br /> cs N _ <br /> W E EPA/Oth <br /> a R <br /> v A c stat. <br /> 6 T <br /> m EPA/Other <br /> R <br /> °e <br /> w d. <br /> State <br /> H <br /> W EPA/Other <br /> V <br /> w <br /> to J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above <br /> Z <br /> O Ila) Profi/^l�ef 290311-09 b <br /> owc Sx5r;5 441— ZIP" <br /> 3 c. d. <br /> Z <br /> Z <br /> O 15. Special Handling Instructions and Additional Information <br /> Z HANDLERS BE 40 HOUR OSHA/SARA TRAINED <br /> xW AND USE NIOSH APPROVED PPE.EMERGENCY CONTACT: (916) �0 <br /> _ <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully an accurately described above by properehip ing name and are classified,packed, <br /> Vmarked,and labeled,and are in all respects in proper condition For transport by highway according to applicable international and nationaPgovernment regulations. <br /> II I ora o large quantity generator,I certify that have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economicallyY <br /> LL prxticable 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 health <br /> and the environment;OR,if I am a small quantity generator,1 have made a good faith eFfoH to minimize my waste generation and select the best waste management method that is <br /> available to me and That I can afford. <br /> OPHnled/Typed Name Signature Month Day Year <br /> z , / <br /> 4O T 1Y.'-Trans r 1 Acknowled ement of Receipt of Mamriols ` <br /> , Printed/T d Name Siimmuro /"`' nd� Day Year <br /> W F <br /> w : D <br /> P <br /> 0 IR. Transporter 2 Acknowledement ofReceipt oF Materials <br /> 0 T Primed/Typed Name SignatureMonth Day Year <br /> w L <br /> F <br /> 19. Discmpanry Indication Space <br /> Z E <br /> _ A <br /> C <br /> I <br /> E <br /> 20. Facili Owner or O rotor GHiFmtion of receipt of hazardous materials covered this manifest except as noted in Item 19. <br /> 7 Prinftd/Typed Name Signature Month Day Year <br /> IF <br /> DO NOT WRITE BELOW THIS LINE. <br /> Yellow: GENERATOR RETAINS <br />