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State of Colifornia—EnArcu menial Pegiection Agenryl., <br /> Form Approvbd OMB No.2050-0039_Expires 9-30-99) See Instructions on back of Inge 6. ',,r7 DepaHnntttof Taut Subsw.cn ConlmL <br /> Deese Ont or type. orm designed.4use on efffe(IZrpifch)t iter. Secamanto,California <br /> UNIFORM HAZARDOUS 1. enemtor's Us EPA ID Na. Manifest Document No 2. PagI Information in the shaded areas <br /> WASTE MANIFEST A 0 DE 0 3 9 1f; <br /> not required by Federal low. <br /> ,,,JF eroW6,6 m Lg 6M61 ms X State Mamfest Decurrent Number `o c C <br /> 151 E. ALMONDWOOD DP,. . MANTECA CA 9333:? gRR91V25 <br /> B Siete Generator's ID <br /> n �•A. Generator's Phone f`f"/'-f )239-1361 <br /> N <br /> S. Trans Qorbr 1 Com ny Name 6. US EPA ID Numbep C. State Transporter',ID <br /> m OR I-,AL O�L C AD 9 82 4 1? 2 55 -- <br /> ,-s ?rens orter's Phone <br /> �j p c�Od�a6, X63. <br /> m 7. Tronsporter 2 Company Name 8. US EPA ID Number E. Store Transporter',ID <br /> Q - Tran,parter's Phone <br /> V Na ss <br /> 10. US EPA ID Number State Facility',ID <br /> 7Q I�V�Pf�gf �` C5 OIL CO. � <br /> 41 170Q S. SOZfle_ST. ' <br /> DO LOS ANGELES. CA. 9Q023 C. A 0 9 4 7 Op <br /> . Fadhy',Pone _ <br /> 1).'c I1. US DOT Description(including Proper Shipping Name,Hazard Class,and IDN Number) 12. Containers 13. Total IA. Unit s <br /> P I� 8 P PF'n9 ) No. T Quantity Wt/Z I. Waste Numher <br /> wz <br /> 0= NO)%—RCRA HAZARDOUS WASTE LIQUID 5Qe <br /> 43 G (WATER & SLUDGE) G OS IT T 13 EPA/o her <br /> .O N b. State t <br /> w E .`. <br /> 4 R - EPA/Other. <br /> a A <br /> o T <br /> ct O <br /> R EPA/Other <br /> Fd. stale <br /> z <br /> w <br /> V EPA/Other <br /> W <br /> Z1. Additional Descriptions for Materials Listed Above . K...HarAing Code,far Wastes listed Above <br /> TANK' BOTTOM WASTE s . a f 6 <br /> Rof <br /> IISATE L <br /> a <br /> 0 15. Sp«ial Handling Inshuctions and Additional Information _ <br /> Ql"PPOPP.IATE PROTECTIVE CLOTHING <br /> z "EMERGENCY CE)NTACT. (209)541-9145,1 <br /> '= EE E. R. G. 171 <br /> 16. GENERATOR'S CERTIFICATION: I hereby d«lore that the contents"is coni nment are fully and accuratel described abowb <br /> Q marked,and labeled,and are in all res bin proper g y y proper shipping name and are classified,packed, <br /> V p« p per condition for transport by highway according to applicable inHmational and notionol government regulations. <br /> If 1 am a large quantity generator,I cerfiFy that I have a program in place ro reduco Ste volume and toxicity nF waste genemtea ro the deer_~!have determined b be«anorn;ceA� <br /> d practicable and that I have selected the rocfical to method a treatment,storage,or disposal currondy amiloble tome whit ptinimizes the present and future threat to human h«ISS <br /> and the environment;OR,if I am a small quantity generator,I have made a good faith effort b minimize my waste enera/IQn and select the best wash management method that is <br /> O available to me and that I can afford. _ t/r <br /> y Printed/Typed - Signature Month Day Fear <br /> Z 1�. ` : i .eZ / i <br /> W 1 17. Trams,r I Ackn ement of R«ai t of Materials / / <br /> U $ Printed/Typed Name //6sI✓'� {/ ! Sigpature Month Day Ygor _ <br /> P <br /> O0 7 S. Transporter 2 Acknowled ement of Receipt of Materials <br /> TPrinted/Typed Name Signature Mundt Day Year <br /> W E <br /> a R <br /> V 79. Discrepancy Indication space <br /> Z P <br /> — a <br /> c <br /> I <br /> L <br /> 1 20. F ner or er Certif do f r«ei t of hazardous materials covered i an' exce s n201inItemI9. <br /> T Prin NameSignator{ Mon Day Y <br /> Y // <br /> DO NOT I ELO THIS LINE. <br /> DTSC 8022A(A/97) <br /> -EPA 8700-22 ..Green: TRANSPORTER RETAINS <br />