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1197 VANR>RRItT C111. #2 <br /> ALIMNIA COOLANT SERVICE - MANTECA, CA 95337 <br /> `Your California Antifreeze Service Company" OFFICE: 209-239-5587 <br /> Transporter EPA#CAR000047167 Fox: 209.239.631611 <br /> SERVICE ORDER: 44 999 <br /> o Spedahtes(SRKHE10MOgAl8) MANIFEST S <br /> "otfta,aa�r U <br /> 8�8 81� �8� EHs Bf��Ff� #6�3 Es c _�m i 9tna�9e T@FrRR: NE199 Aso; Lujo MKN1;1Ae <br /> 50/50 AT <br /> --5 J <br /> 50 WasteAntireezePict:-U �J c <br /> Tank Serial Numbers: <br /> Non Taxable Sub Total / J � <br /> Taxable Sub Total ` r <br /> Tax <br /> TOTAL DUEWASTE DISPOSAL <br /> -1 NON-RCRA HAZARDOUS WASTE,LIQUID(OILY WA rn)NO PLACARDS REQUIRED'ORMAION <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)•NO PLACARDS REQUIRED' STATE CODE 221 <br /> 7 OTHER:_ _ <br /> STATE CODE 134 <br /> J DESIGNATEDTSOF: --- <br /> 3 DEMENNWKERDOON: 20M N.AIM002 Street-Compton,CA 90222-CAT080013352-(310)537-7100 <br /> J DM DIXON: 73110 Chevron Way•Dixon,CA 95620-CAT080012602-(707)693.6008 <br /> U RAMOS ENVIRONMENTAL: 1515 S.River Road-W.Sacramento,CA 95691°CA0044003556•(916)371-5747 �' <br /> �( NU-SET INDUSTRIES: 977 South 700 Weal-Sall Lake City,UT 84104-UTD982589459•(801)977-0220 <br /> �` <br /> J A TERNATE TSDF:_ _ <br /> J CPR: 33210 Western Avenue-Union City,CA 94587•(510)487-9277 — <br /> I <br /> (All Generatore7Customers MUST relied the following text.) <br /> it l am a large Quantity generator.I candy That 1 have a program In Place to reduce the volume and toxicity,of waste generated to the degree I have determined to Da economicaly <br /> practicable and that I hew selected the practicable method Of treatment,storage,or disposal currently available to me which minimize the presets and future threat to human <br /> Ida and the environment; Or,4 1 am a small quantity generator,I have made a good falth to minimize my waste genera0dn and select the best waste management method that <br /> is aveiiabie ip me that I can axord. <br /> 'I HEREBY CERTIFY THAT t HAVE NOT MIXED THIS WASTE WITH ANY OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.td_A(Jp THAT THE WASTE GOES <br /> NOT CONTAIN ANY P-C.9'S. ..� % <br /> � I <br /> 'I FURTHER AGRE ACCEPT THE ADDITIONAL CHARGES FOR LEGAL DISPOSAL IF THIS WASTE IS OVER.1000 P P AIH R P.C.e'S <br /> h <br /> , <br /> C SgnaWre __—._ <br /> Date <br /> . r - _ . _ _C9_��-� <br /> Date <br /> J <br /> Print Name Prim Odvar'S Name <br /> All returned ehseks m subjeot to 0 815.00 Service Charge. <br /> Adismounts not paid Within 30 drys of ImIGIce ere eubIW to 1 112%interest per month,'18%annually on unpaid baronies. <br />