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NON HAZAROOUS WASTL- MANIFEST <br />UNIFIED GROCERS <br />Jia PICCOLI ROAD <br />ADDRESS <br />STOCKTON CA <br />CITY, STATE <br />209-931-1990 <br />PHONE <br />EPA NUMBER: <br />71664-1 <br />ENVIRONMENTAL HEALTH MANIFEST NUMBER <br />LIST COMPONENTS: <br />A. DIRT n <br />E. WATER <br />C. <br />D. <br />PHYSICAL STATE: <br />WASTE DESCRIPTION: DIRTY WATER <br />GENERATING PROCESS:OLARIFIERMRTER <br />SPECIAL INFORMATION: PROFILE#54948 <br />THE GENERATOR CERTIFIES THAT <br />THE WASTE AS DESCRIBED IS 100% X <br />NON -HAZARDOUS. <br />DATE <br />Vb�lp_ <br />QUANTITY <br />% <br />E. I <br />F. <br />G. <br />H. <br />EJ Liquid <br />rrrrrwrrrrrr <br />MEOW <br />rags /IVC. <br />P.O. Box S 1 Z9 - San Bernardino, CA 92412 • (909) 889-5607 <br />D.O.H.S. ##01 15 ■ EPA #CAT 080012800 <br />K -PURE WATERWORKS J 1 <br />10 ROCHESTER AVENUE <br />RANCHO CUCAMONGA CA 91730 <br />zi <br />9M476-9492 <br />EPA NUMBER: <br />QUANTITY <br />C1 Solid <br />TRUCK # 3'�) <br />PIU DATE: 3, z7, G <br />IER # <br />X <br />SPECIAL HANDLING <br />OR DISPOSAL METHOD <br />PH. <br />V <br />