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, .5lo,,ofCtJi(ornio—EnvironmentalProtection Agq{,cy 1 Sep Insfructions on back of page 6. Departmenloflax,,5abormcn,Can,,,
<br /> T FPrmpaP"rMed OMB No.2050-0039(Expires 9-80-99�,
<br /> Q»a ppnI or Ippe. Farm designed For use on able E 9 7xwriler. 5.. .nlo,California
<br /> r 1. Generator's US EPA 1Wdo. Manlfasl Docvmen n 7 Paye 1 Informntirn,in the shaded areas
<br /> UNIFORM HAZARDOUS s not,.q,d,.d 6y rednrnl law
<br /> WASTE MANIFEST 1 2: Q Q Q O 1 °I 1
<br /> 3. General.,',Name.ad Moiling Address A. Slate Manifest Document Number
<br /> ARCO PRODUCTS CO. 20831080
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<br /> 4 CENTARPOINTE DR.; LA PALMA, CA 90623-1066 B. Slate Generaloi s ID
<br /> n A. Generator's Phone 1925 1299-8841 Paul 6upplo
<br /> N 5. Transporter 1 Company Name 6, US EPA ID Number C. State Transpoder's ID[Reserved.)
<br /> "7,s �,s �E r� /� ,�/�
<br /> 0 ADAMS SERVIC99, INC, CAL 9 1212 1 2 5 6 6OP 8 D. Transporler's Phone 310-523-4430
<br /> °D 7. Transporter 2 Company Name 8. US EPA ID Number E. State T,.nsp°rler's ID[Res.d.)
<br /> —s I F. Transporter's Phone
<br /> V 9. Des{ M& WMwUddrass 10. US EPA ID Number 6 Aj 16D Q " J 3 445
<br /> HZ 2000 He ALAMEDA ST. H. Facility's Phone
<br /> "F70 COMP'TON, CA 90222 CAT 0 8 10 10 1113 315 12 310-337-7100
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<br /> 12. Containers 13. Total Id. Unit
<br /> 11. US DOT Description lincluding Proper Shipping Name,Hazmd Class,and ID NumbQu
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<br /> V No. T Quantity WI/Vol I. Waste Number.
<br /> N Z (OIL & WATERS NON-R.C,R,A. State 2k1
<br /> 3 c 11AZARMTS 'riASTE LIQUID & 01011 T T G EPA;o h.r
<br /> o N 6' -. State
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<br /> R - EPA/Other
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<br /> R EPA/Other
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<br /> s's EPA/Other
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<br /> T Additional Descripfions for Mater ols Listed Ab... K..Handling Codes(.r Waste's Listed Ab
<br /> 992 WATER K f • " a O1 b.
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<br /> 9 15. Special Handling Instructions and Additional Information " r
<br /> s, i- DON PROPER PROTECTIVE GEAR 3518 E. hammer Ln. I Stockton, CA.
<br /> Z NO SMOKINGT E.R.G. 027" `. ..
<br /> = EMERGENCY Int 925-299-8891 Contractort R. E. Curtis Construction, Inc,
<br /> J 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment arefully and accurolely described a6.ve by proper shipping name and are classified,packed,
<br /> Vmarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and nationaPgovernment regulation,.
<br /> If I can a large quantity s
<br /> generator,I certify that I have°program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically
<br /> a- prac ica6le and that I hove elected the practicable method o treatment,storage,or disposal currently available to me which minimizes the present and future threat to human heals
<br /> sad the environment;OR,if)am a smaquantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is
<br /> ad available to on,and that I can afford.
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<br /> Printed ame J C + �, nature - Month
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<br /> 17.'Tr'an'spoftr 1 Acknowled .meat 61 Receipt of Materials
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<br /> W ,R Pri /T d Nome Signature .nth Yeor
<br /> d18. Trans rte,2 Acknowledgement of Receipt of Materials
<br /> O R Printed/Typed Name Signature Month Day .Year
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<br /> V19. Discrepancy Indication Space
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<br /> 1— 20: Fedli' Own-or O s—t.r C.,611 tam of -i t of hazard..,mated.b covered 6 this ani " = t e,n
<br /> ":h.Ied Ina, A 9.
<br /> "T` : t dr'ivpN.me Sign.ro ,A Mae,h/ 'nNI r
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<br /> Y SILL II LI
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<br /> DO NOT WRITE BELO .`THIS LINE.
<br /> DISC 8022A 1/991
<br /> EPA 8700-22 Green. fRArla',111 ItG Pf TAINS
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