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Form Approved OMB No.2050-0039(Expires 9-30-99) See Instructions on back of image 6. <br /> Please print or 1YPe. Form designed hr use o^elite f 18pifch rib,. Deportment of Toxic substances Control <br /> Sacramento,California <br /> 15H <br /> HAZARDOUS Ganeraror'a US EPA ID No. Manifest Do ument Ne 2. Page 7 nfe motion in he shaded areasMANIFEST s, is nor required by Federal law0 i 4r:. �;, of3. and Mailing Address A. Slate Manifest Document NumberELIFORNIA TR'AI_TION 1_[j, 9��2�782 ;"o h.4k:EE RD. , STOCK:TON, Cry 95205 B. Star.Generator'slD4. [l',lq )466-6 927 <br /> N 5. Tmnsporhr 1 Company Nama 6. US EPA ID Number C. State Tronspori ID <br /> qOp CAL OIL - _ <br /> o A 9 4 <br /> + J D. Transporter's Phone <br /> 0 7. Transporter 2 Com Name <br /> P f�"Y 8. US EPA ID Number E. State Tronsporter'e ID ZO 9 - <br /> Q E Transporror's Phana <br /> V 9. Designated Facility Name and sib Address 10. US EPA ID Number G. Stota facility's ID <br /> d INDUSTRIAL SERVICE OIL CO, <br /> NW 700 S. SO T O ST. H. Facility's Phone <br /> 00u- OS ANGELES. CA. 97023 <br /> A. xi , <br /> ~Q 12. Containers 13. Total IG. Unit <br /> ,V 11. US DOT Description)including Proper Shipping Name,Hazard Class,and ID Number) No. Type Quantity Wt/Vol 1, Waste Number <br /> ciiiVs ate <br /> L X ON-RCRA HAZARDOUS WASTE LIQUID <br /> 003 G (WATER & SLUDr9Ei T / n v EPA/Other <br /> E � ,, / <br /> �o N It. sro. <br /> E <br /> R EPA/Other <br /> a A <br /> o T sroro <br /> m O <br /> R EPA/Other <br /> Score <br /> Z <br /> w <br /> V EPA/Other <br /> w <br /> w <br /> Z J. Additional Descriptions for Materials Listed Above K. Handling Code.for Wastes Used Above <br /> TANK BOTTOM WASTE b. <br /> o< RINSATEd. <br /> a <br /> 0 15, Special Handling Instructions and Addirional Information <br /> 1— FC'RCPR I ATE Pr:0 i ECT i') <br /> Z 'EMERGENCY CONTACT. ' 0'9 '541—'9145" t <br /> EE E. P.r,, 171 <br /> Q 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurchi,described above by proper shipping name and are classified,packed, <br /> V marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> J If I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be�canomical]Y i <br /> ypracticable and that have selected the practicable method of treatment,storage,or disposal currently ovoilable tame which minimizes the present and future threatro human I= _ <br /> act and the environment;OR,if I am a small quantity generator,I have made a good faith effort w min' ' y waste generation and select the best waste management method that is <br /> O available to me and that I can afford. <br /> y Printed/Typ a �.+ , Signature onth Day ear <br /> w B 77. Trans iter 7 Acknowlad ement of Racai t of Materials <br /> 1 Primax0yped Name / / Signa I,.j .�J N/pnils oy, Yea <br /> VS <br /> W 0 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> O I Printed/Typed Name Signalum Month Day Year <br /> W E <br /> Q R <br /> V F 19. Discrepancy Indication Space <br /> Z A <br /> C <br /> f 1 20. Facility Owner or Operator Certification of recei t of hazardous materials covered by this manifest except as noted in Item 19. <br /> T I Printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A (4/97) <br /> EPA 8700-22 `lellow_ Gc'N Eflai CR REINS <br />