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State of California—Environmental Protection Agency <br /> Form Approved OMB No.2050-0039(Expirss 9-30-99) see Instructions On back Of PO 6. Depamnent of Tonic Substances ControlMeow PnM or type. Form designed for ase on dib(12-pitah)Drum <br /> Sacrament,California <br /> UNIEORM HAZARDOUS • Caneralor's US EPA ID No. Manifest Document'No. 2. Page I InFor,.tion in the shaded area <br /> WASTE MANIFEST is not required by Federal law. <br /> 3. Genarati s Name and Mailing Address OLWIm SEROICE Swim beer 985083307 <br /> 11TH 6 CIOUM-AN RD. <br /> (209) 482-7769TAAC! CA95376 8.'+State Gem.rabr'S ID <br /> • . <br /> A. Generator's Phone ( ) <br /> � 5. Transporter I Company Name 6. US EPA ID Number c Stare Tronaporte/s ID <br /> g ASBURY IS SERVICES D. rrannportersPhane 1310?886-3400 <br /> 00 7. Transporter 2 Com n Name <br /> company S. US EPA ID Number L Sete Tramporer's ID <br /> Q F. Transporrols Phone <br /> V 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Focilir,'s ID <br /> a DEMENNO KERDOON ry�pT�ykissel <br /> 0OF M H1H MMM MEET, C✓I TIA CA %M <br /> H. Fancy.Phone <br /> Mo 7112. <br /> (318)537-7180 <br /> CDUMQI1. US DOT Descri ton ncludi Pro Shi n Name,Hazard Class,and lD Numberletloers 13. Total 14. Unit <br /> Pi G ng fKK PPi 9 Type Ouonhry Wr/Vol I. West.Number <br /> �= aNON-RCRA HAZARDOUS WASTE, LIQUID Cp3 G (WATER,OIL) No Placard EPA/ lerNE -r G NONE <br /> m N b' State <br /> m E <br /> N R EPA/Other <br /> v A <br /> oT stae <br /> m O <br /> R EPA/Odser <br /> d' state <br /> Z <br /> w <br /> V <br /> w <br /> N <br /> Z <br /> O <br /> P <br /> Z 15. Special Handling Instructions and Additional Information 0®L 538 <br /> Q <br /> Z 9LMS 4 GOGGLES ENEAGENCY CONTACT:MEL HA"OR -ft—tR398^7 <br /> w -- <br /> (310) 560-3210 <br /> r 16. GENERATOR'S CERTIFICATION: Thereby declare that the contents of this tenni nment are Fully and accurate) described above o skip in name and are classified, <br /> g y y proper p g packed, <br /> V marked,and labeled,and are in all respects in proper condition Far transport by highway according t applicable international and nationargovernment regulations. <br /> If I am o large quantity generator,I certify that have a program in place ro reduce the volume and toxicity of waste generated to the degree I have determined to b9 economically <br /> as. Practicable and that have selected the practicable method aF treaunent,storage,or disposal currently available ro me which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> OF <br /> O available to..and that I can afford. <br /> Z 1PfiRleil/Typed /�e ,// Z S re Month Day year <br /> W M . transporter 1 Ackin hudgerment of Receipt of Materials <br /> :E Printed/TypedN ma Signabre I I Month6 Doy Year <br /> O0 18. Trans crier 2 Acknowleoot d apt 1 of Materials ! ' <br /> TPrinted/Typed Names Signature Month DayYear <br /> w E <br /> Q R <br /> V F 19. Discrepancy Indication Space <br /> Z A <br /> C <br /> I <br /> L <br /> I 20. Facilint,Owner or Om rater certification of receipt of hazardous maleriab covered by this manifest except as noted in Trom 19. <br /> T Printed/Typed Name Signature - Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DISC 8022A (4/97) <br /> EPA 8700-22 Yellow: GENERATOR RETAINS <br />