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-State Of Celi(omia--Environmanpl Protection Agency <br />Form Approved OMB No. 2050-0039 (Expires 9-3a 991 <br />Pleaseprint'Ytype. form dmignedlar unor,.lib 112 -pi <br />u <br />f <br />a <br />C <br />C <br />a <br />i <br />pewriter. <br />IRSF811 <br />DO NOT'WRITE BELOW THIS UNE. <br />DTSC 8022A (4/97) <br />EPA 8700-22 <br />Green: TRANSPORTER RETAINS <br />61r 't✓'"$ ., <br />UNIFORM HAZARDOUS 1. Generator's US EPA ID No t% ' � % Man fest Docamanl,Ns ^,Z, <br />Page 1 ., Informationsn the shaded areas <br />✓u rm[tequ by Federal law tt. <br />WASTE MANIFEST <br />re <br />3. Generators Nome and Mailing Address <br />,AYMOND LOPEZ <br />42 N. AIRPORT WAY, STOCKTON. CA 95205 <br />4. Generators Phone 209 1462-0253 <br />I <br />S. Transporter I Company Name 6. US EPA ID Number _ <br />!OR CAL OIL C AD 9 82 4 17 2 5.@, <br />7. Transporter 2 Company N <br />Po Po Yame 8. U$ EPA ID Number <br />9. Desi noted Facility Name and Site Address 10. U$ EPA ID Number <br />TNDU�aTRIAL SERVICE OIL CO. f. ; <br />700 S. SOT+]:, -ST. <br />_OS.ANGELES. CA. 90023 P 1AP7 9' 5 '7 0 <br />11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) - 12. Conteinars 13. <br />Tete) <br />U. UnitNa. <br />Ty Ouantiy Wt/vol <br />Ott--RCRA HAZARDOUS WASTE LIQUID <br />+:WATER & SLUDGE)0 01 7 <br />g <br />t <br />N <br />Is. <br />E <br />R <br />A <br />T- <br />O <br />d. <br />`fon r tori" <br />15. Special Handling Instrucfions and AddiBanal Information <br />PPROPRIATE PROTECTIVE CLOTHING <br />EMERGENCY CONTACT: (209)541-9145" <br />d <br />EE E.R.G. 171 i+'G":x�.ir„��<,g'. <br />'art <br />r. <br />16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment aro Uly and accurately described above(s(��.. propershippingrwmeaedareclassified,packed, <br />marked, and labeled, and are in all respech in proper condition for transport by highway according to applicable intemaion tc! - 5. <br />national <br />government regulations. <br />If I am a large quantify generator, I certify that 1 have o p ram in place b reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br />Isand that 1 have selected the practicable method of treatment, storage, or disposal currently mailable to me which minimizes <br />the future threat b human health <br />present and <br />and the emironment; OR, if I am a small quantity generator, I have made a good faith on and select Its best waste management. method that is <br />available to me and that 1 can .ford. <br />Printed/Typ/� <br />Signature - <br />M.nDay Year7j� <br />i <br />l <br />r <br />T <br />R <br />17. Trans rter 1 Acknowled .meat of Recei t of Materials - <br />APrintad/Typed <br />Nams <br />Signature <br />Month Year - <br />�f <br />i 5 <br />R18. <br />Transporter 2 Acknowled amort of Receipt of Materials <br />T <br />Printed/Typed Name <br />Signature <br />Morelli Year <br />19. Discrepancy Indication -Space <br />.. <br />A <br />.. <br />E <br />... <br />1 <br />20. Facili O orator Ceaific.tion of reri t of hazard... materials <br />covered b axce t noted in Item 19. <br />TIPrintad/TY <br />r v ` <br />SignaNr _ <br />Abin� 2Dvy tear <br />DO NOT'WRITE BELOW THIS UNE. <br />DTSC 8022A (4/97) <br />EPA 8700-22 <br />Green: TRANSPORTER RETAINS <br />