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Stale of Cahfomio—Emironmerml Protection Agency —185-01 See Instructions on back of Department 6. Depaneof Task Substances Central
<br /> Fone Approwd''0M6 No.2050-00.19(Expires" 96) `/ socramento,California
<br /> please Pnm or". Form designed for use on euro(12-girth)ypewziter.
<br /> 1. Gmerator's US EPA ID No. Manifest Document No. - 2. Page 1 Information in the shaded arms
<br /> UNIFORM HAZARDOUS 1 is rat required by Federal law.
<br /> WASTE MANIFEST CAD 98197 228 20912 o11 f
<br /> A. State Manifest Document Number r �.s^/ •.-f•
<br /> 3. Ge Name and Mailing Address VA sS g 71 1 i4 y `.
<br /> 2 AUTO CTR CIRCLE Y f VJJw/
<br /> 8, Stale Generator's ID
<br /> TOCKTON CA
<br /> CA 95212
<br /> I I I ( I I I I I 1 I I I
<br /> ev 4. Geron rim',Phone 209) 956-6711
<br /> W C. State Tromporters ID
<br /> 5. Transporter 1 Company Name b. US EPA ID Number 602917
<br /> AFETY—KLEEN CORP. LD 9 49 8 02 D. Tranpo er',Phone
<br /> 00 669-5740
<br /> Q 7. TrampoMr,2 Company Name
<br /> 8. US EPA ID.Number E State Tranzporter's ID
<br /> Tramportef's Phase
<br /> e} a '> c;. stat F ;:ID 1 9b
<br /> a)Z 9 pFetyggI F I' me ddress 10. US EPA ID Number 1111---
<br /> 0 0 5050 SLI DAA BLVD H. Facility's Ph-ne
<br /> O LL ALIDA, CA 45368 CAT 000613968 209 545-1011
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<br /> U 12 Comainers 17, Tocol 14. Unit '.
<br /> C" Z 11. US DOT Descripion( cos
<br /> tincluding Proper Shipping Na ,Hazard Class,and ID Number) No. T Quantity Wt'v.1 L Waste Number
<br /> = State 741
<br /> Cit WASTE COMBUSTIBLE LIQUID, N. O. S. DM !
<br /> (PETROLEUM NAPHTHA) NA1993 PGI I I (DO01) t EPA/Od'er DOO1
<br /> E (DO06, D008, D018, D035, 9039, D040) (ERG#27)
<br /> N b. RQ WASTE COMBUSTIBLE LIQUID. N. O. S. stoe 741
<br /> R (PETROLEUM NAPHTHA) NA1993 PGIII (DOOi) DM G EPAJotherDOO1
<br /> h A
<br /> (DO06. DOOR, D018. DO35, DO39, DO40) (ERG#27)
<br /> °? T 741
<br /> WASTE COMPOUNDS. CLEANING LIQUID
<br /> o (MONOETHANOLAMINE)8 NA1760 PGIII (ERG#60) J DM It G EPA/OtherD006
<br /> R (D006. D008, D018, D027. D039, D040>7. 9#/GAL /
<br /> W
<br /> Z
<br /> e. WASTE COMBUSTIBLE LIQUID, N. O. S. Jate 213
<br /> (PETROLEUM NAPHTHA)NA1993 PGIII DM SII G EPA/ohe
<br /> (DOOS, D018. DO39, D040) (ERG#27)6, 7#/,^,AI_ CJI D034
<br /> OAdditional tions for Matoriols fisted A w K. Handling Codes for Wastes Listed Above
<br /> 1 �(A> D03 D018 (A)' 006, D008, DO'35, D040 b.
<br /> W 14 AND Oi 14 AND Oi
<br /> I(B) D039 D018 (B) D006. DO08, D035, DO40
<br /> I(C) D008 DO18 (C) DOW D039, 0040
<br /> a (0)' D008v DO 18, DO40 °. 14 AND 01 d I ( 4
<br /> Z 3 Lc dV' x --r8-5---OT— b
<br /> Q IS.i7'al Handlin Instructions and Additional Information
<br /> z
<br /> EM NC RESP#800-468-1760 24HR
<br /> z
<br /> = SKDOT# A: 501 B: 585 C: 950 D: 975
<br /> f
<br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this comignment are fully and accurately described above by proper shipping mrro and are classified.
<br /> Qpacked,marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable imornatianal and mtia,al gowmmenr regulations.
<br /> U
<br /> If 1 am a large quo" generator, I certify that I haw a program in place to reduce the wlume and toxicity of waste generated to the degree I haw determined to be
<br /> vecoramkally practicable and Mat I haw setecied the practicable method of treatment,storage,or disposal currently available Is,rte which minimizes the present and future
<br /> N threat to human heath and the environment; OR, R 1 am a ..If quantity generator, I haw made a good fait,effort to minimize my waste generation and select the best
<br /> waste management method that is awilable to me and that I can afford.
<br /> O Primed/Typedlt7 Sinatureril9el LCA^,��o °
<br /> Z T 17. Transporter 1 Ackrawbd emert of ReceiE of Materials 59 1
<br /> A Pri Md/;yPedNo.RNoel e� Signature �/ /- ,C / . r
<br /> W S
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<br /> W 0 18. T fu
<br /> r 2 A< awlad annt eof Receipt of Materials
<br /> IfPrimed/Typem
<br /> d Noe Signature Month Day Year
<br /> LL T
<br /> 0 RE
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<br /> N 19. Docrepavy Indianan m Spa
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<br /> U A
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<br /> 1 20. Feil' Ower or ratty
<br /> iCertification of recd t of haxordau,materials covered b this manifest exceptas noted in tem 19.
<br /> �{� 'l�t' SigmN ,�y.y Month i s Year
<br /> DO NOT WRITE BELOW THIS UNE.
<br /> Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS.
<br /> (Generators who submit hazardous waste for transport out-of-state,
<br /> DISC 8d12A (1/95) produce comoleted copy of this copy and send to DTSC within 30 days.)
<br /> EPA 870D-22
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