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,. ..... <br /> Sacramento,California <br /> Y UNIFORM HAZARDOUS 1' vror's US EPA ID No. Manifest Document No. 2, Page I Information in the shaded arms <br /> WASTE.MANIFEST .:: G 4 6 6 3 3 2 4 7.:rl of a not required by Federal lw. <br /> 1 <br /> 3. Ghwrab/s Nmme and MaOitp Address <br /> ,AD ART : i <br /> P. D. BOX 8570, STOCKTON, CA 95202 <br /> A Generator's Phan,(2(.191 931-7772 <br /> s- <br /> 5. Transporter 1 Company Name 6. US EPA ID Number <br /> s NOR CAL OIL C AD 9 82 4 17 2 55 <br /> (c <br /> ' I 7. TransporterI Company Name, ' '=„ A 1D Number <br /> 9. Designated Facility Nome and Sib Address 10. .,• PA ID Number <br /> < INDUSTRIAL SERVICE OIL C0. ' <br /> z 1700 S. SOTO ST. <br /> LOS ANGELES. CA. 90023 101 9D I 0I q9141 <br /> V 11. US DOT Deseriptim(including Proper Shipping Nome Hazard Claw,and ID Number) 'st. 12. Cmbines, 13. Toldt. 1 d. Unit <br /> ' f <br /> I .." No: T Quantity Wt/Val <br /> Nd —P.CPA HAZAF_DOUS WASTE LIQUID _ <br /> (WATEP Er SLUDGE? — 0 01 T T <br /> E .. <br /> C N b: <br /> ao E <br /> R j <br /> ' I A ti <br /> o T C. <br /> od. <br /> e <br /> u <br /> o #y; <br /> U <br /> Z 15. Special Handling Instructims and Additional Inf rmcnion: <br /> APPROPRIATE PROTECTIVE CLOTHING SITE 'ADDRESS- <br /> "EMERGENCY CONTACTs (209)541 9145" 3133 AD ART RD. <br /> it SEE E.P.G. 171 STOCKTON. CA <br /> 16. GENERATOR'S CERTIFICATION: I hereby dxlare that the contents of this consignment are fully and oceuntely described above by proper shipping ncm and are cI..ihm1,pocked, <br /> marked,and labeled,and are in all nspxts in proper condition for transport by highwy according ro op able inromafional and nvtimal govemment regulations. <br /> If I am a large mntity generator,I earth that 1 have a ro n in <br /> a g q h g (y' drag placer reduce the sal cu and toxicity of waste <br /> me which mi ro the degree I have determined b be ecanomieally <br /> v practicable and that I me wlxMd the Pratlieable method al hmhnent,'forage,or itis-gal currently ovailabk ro me which minimizes the present and Future threat ro human hmlth <br /> ons : t t:e-s:,. quafty voacr-_�.-_q!6-.x=ode o gam s-i!h e1fvo to nir.:-•.-.—y.+ah.e--.me,...„nd r.hhrt tis.be.r h.,ste mmv.eement method that is <br /> awilable b me and that I can afford. <br /> } Printed/Typed Name Signature Mmllh Day r <br /> (ri <br /> Pviu <br /> u .T 17. Transporter 1 Acknwled ment of Receipt oI Materials <br /> jPrinted/Typed Name Signature • M D evr <br /> W KEN S. PUETT <br /> uh f <br /> u B i 18. Trans rter 2 Acknowled emmt of Receipt of Materials - - <br /> T- Printed/Typed Name Signabn - Month Day year.- <br /> Q <br /> v19. Discrepancy Indication Space <br /> 1 �; <br /> J 20. Facility Owner or ator CertiPhmton of receipt of hazardous matxivls cewrad by this manihatexceecs noned in Its.19. - <br /> T PriMed�Ilgeed,Na r� -�� 3 pmNn / tis Day + . Yea'T yr <br /> k b DO NOT WR& BELOW IS LINE <br /> lik <br /> JTDTISC 8622A IA/971 d <br /> Fol,8700-22 r Green TRANSPORTER RETAINS s. <br />