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NON-HAZARDOUS 1.Generators US EPA 10 No. 2.Page 1 - 43.Document Number <br /> WASTE MANIFEST — of 1 NH— N`" 45131 <br /> 11 a.Ggraralors Nem§Sau�� Addy/e�(+ <br /> /[S/✓N INS!/ <br /> y <br /> ' GBne'rata's Phone _ _ <br /> 5.Transporter Company Name 6. US EPA ID Number 7.Twneppgr Phoriti <br /> CLEARWATER ENVIRONMENTAL CAR000007013 10 797-8511 <br /> B.Designated facility Name and Sits Address8. US EPA ID Number 10.FeoPhone ' <br /> r .. <br /> ALVISO INDEPENDENT OIL <br /> 5002 ARCHER STREET <br /> G ALVISO, CA 95002 CAL000161743 10 797-8511 <br /> E 11.Waste Shipping Name and Description 12.Con Total Unit <br /> N . <br /> E - No. Tvps auuintith, wWd <br /> A a <br /> T Non-Hazardous waste, liquid <br /> 0 - 001 TT G <br /> p r G y <br /> t <br /> Facial ng - <br /> 15.3 Handli Instructions and Additional Infonnetlon ` _ Handling Code's for Wastes AEove . <br /> .Wear PPE <br /> Ila. ne. <br /> Emergency Contact f <br /> (510) 797-8511 <br /> Attn: Kirk Ha and S—f <br /> -5 ljzx <br /> 16.GENERATOR'S CERTIFICATION: I certify the materials described above on this manifest are not subject to slate or federal regulations forlepartingproper disposal of Ilatardous Waste. <br /> Phmed/TypeoName 1 Signature - <br /> A 0 <br /> N <br /> S 17.Transporter Acknowledgement of Receipt of Materials 6' i <br /> '0 " ted/TyrName Slplawl r <br /> 71 19§93 - <br /> ` <br /> 18.Dbcrepanry Indkatbn Specs t ' <br /> A ' <br /> C <br /> L <br /> I <br /> T <br /> > �y_ + <br /> Y 19.Facility Ow ar or Operator:Certification ofreceiptof waste materials W,rorad oftmeNlset s es noted In Item te. <br /> PnntedXped Name81pwof �� <br /> ,l S mono DeY Year <br /> Avz <br /> WHITE—ORIGINAL(Return to Generator) YELLOW—TSDF(Retain Copy)`. PINK—TRANSPORTER COPY GOLDENROD—GENERATOR'q COPY'.' <br /> ' r <br />