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NON HAZAADOUS WASTE MANIFEST <br />- . -", r-- a 1 1 � Ir 'N <br />UNIFIED GROCERS M <br />7253-- ' l <br />NAME <br />1990 P!CCOLI ROAD JUL 2 8 2014 <br />MANIrEST -NUMBER' <br />--TE-F-)PESS <br />.STOCKTON.CA E VIROWIVAE�T,AL HEALTH <br />CITY, SfA-FE�- <br />OEPARTMENT ZIP <br />DATE <br />209-931-1990 <br />EPA NUMBER: <br />OVANTITY <br />LIST COMPONENTS.- <br />% <br />0 <br />M <br />A. DIRT E. <br />7 <br />Z <br />M <br />B. F. <br />.—WAIER- <br />C. G. <br />0 <br />M <br />D. El H. <br />PHYSICAL STATE: 7-1 Liquid <br />7 Solid <br />WASTE DESCRIPTION: DIRTY WATER <br />GENERATING PROCESS. CLARIFIER WATER <br />SPECIAL INFORMATION: PROFILF-#54943 <br />THE Gr=NERAT(DR CERTIFIES THAT <br />THE WASTE AS DESCRIBED IS 100% x <br />NON-HAZARQQUS. <br />fw <br />TRUCK# <br />z <br />P/U DATE: <br />0 <br />rans �� <br />M <br />4 <br />1. <br />uman Bernardino, 230 E. Das Street v SBerndiCA 92408 ■ f909) 889-5607 <br />D <br />M <br />D.O.H.S, #0115 w EPA #CAT 060012800 <br />M I <br />I x <br />K -PURE WATERWORKS <br />t�- / '� <br />SPECIAL HANDLING <br />OR DISPOSAL METHOD <br />. . ...... . - --6ATE <br />NA�ME <br />8910 ROCHESTER AVENUE <br />- <br />A D 1) F5 <br />> <br />._RAXXUIQ—CUCAMONQA --QA 9173G <br />0 <br />CITY, STATE 7113 <br />RHONE <br />EPA NUMBER: <br />AUTHOMIZED AGENT <br />QUANTITY <br />