Laserfiche WebLink
q4 y &qS q6 I See Instructions on back o 3e 6. Department of Toxic Suborn Control <br /> 7RD <br /> M(f2 pmmM..wn»r. Sac mama'California <br /> USGenerator's US EPA ID No. Mmlfert Docvrmtm No. 2. Page 1 6drm sf an in the shaded areab not required by Fderal hw. <br /> NIof <br /> Name and Mailirp Addrou "Sfaf'1 Meet pacVmst( . <br /> 7 yV E, ('a r n ♦ 9 / V ,nab Creneraaels Igssftt •. <br /> 4. (tremor's Phone (71 ) JOY 5e, in 8P <br /> S. Transporter I Company Name 6. US EPA ID Number C.C-Stab 7rarnporb/s 1D� <br /> s• <br /> p..Trareperter's,Phone <br /> a7. Transporter 2 mpany Name 8. US EPA ID Number Sfae Tt«tsporters tD t'`"9' <br /> .SA.. <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number G.,S f'ociN✓!ID i µ .i) Y <br /> Gibson 011 / Pilot Petroleums loopA. 01' a <br /> Mo 475 Sea Port Blvdie H.ae ✓ ga}{ x s4•d�.g f ka`p wwa Sz <br /> �< Redwood Cit Ca. 94604 ICAD 0 4 1 2 6 0 7 1012 �` Ci3 -9�3•SSIt . fart <br /> 11. US DOT Descri .ludic Proper Shi Name,Hazard Cl..,and ID Number 12. Containers 18. Total 14. Unit <br /> QZ Ptio^G ngPfH^g ) No. Type Ch. Wt/Vol l Wvsie Nuirbm.r Yg. <br /> rim- <br /> "3: <br /> = { <br /> "3: RQ Hazardous Waste Liquids NOS ORM E <br /> G NA9189 D0181AA r, AHOY"Ap� <br /> r E <br /> m N b. Y_ <br /> C? E <br /> A - Aoeer <br /> 1 11 <br /> T e Stile• `y'iw r <br /> to O <br /> It <br /> Lu <br /> W <br /> r <br /> U EPA/OiM'ki <br /> N <br /> Z J. Additional Derafptionu(«AMlaniols lined Abase - - `4'dY "" K. IhdRnO Codes for W Izded <br /> Hydrocarbon 8i.otture With Wetar ` F a A_ K s i` mob. _ <br /> w 99% Water# 21 ffydreaarbeaa) >k b� i m t 'Ss+ �'Y '-''�,e.-< -3"f-s r.✓ w#`: r .-. <br /> Z 7 i/ <br /> O 15. Special Handling InsM1actions and Add'nnnal Information <br /> Z Gibson 011 Waste Stream Profile ♦ ERG 31 <br /> 24 Hrs Contact(J. Ptt F k v r 24 Hro Phone fY 1 D 9 — y IVY ' ZS y <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the cements of the consignment are fully and accurately deuribed above by proper shipping rem,and aro classified, <br /> Qpocked,marked,and labeled,and are in a1I respeca in proper condition for transport by highway according to applicable federal,stats and international taws. <br /> U <br /> If I am a large quantity generator, I certify that I hast a program in place to reduce the volume and toxicity of waste generated to the degree I harm determined to be <br /> J economically procticoble and Mot I hove selected the practicable method of treamore,snrage, or disposal currently available to me which minimizes the present and furore <br /> yLLj threat to human heaRh and the em norenmt; OR, R I can a small quantity generator. I have made a good faith effort b minimize my wants generation and select the bast <br /> waste management method that is owilable to me and that I con off«d. <br /> O Printed/Typed Name SigroNre Month Day Year <br /> nld `1e 011 / <br /> Z T 17. Tr 1 Acknowledgement of Receipt of Materials <br /> WA H Primed/Typed Non,& Signature Morrlh Day Year <br /> W P <br /> W a <br /> 07PnintedfTyped <br /> newkd mem of Recti t of Materials <br /> W 7 Signature Month DaYear <br /> ONation Space <br /> U F <br /> A <br /> Z I <br /> 1 <br /> I <br /> f 20. Facility Ovn,&r or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in hem 19. <br /> T Primed/Typed NameSignmure Month Day Year <br /> Y Oft ( 03/1 <br /> DO NOT WRITE BELOW THIS UNE. <br /> •Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 D <br /> DISC BO22A (12/91) (Generators who wbma il hozardowaste for h«apont out <br /> EPA 8706-22 produce completed copy of this copy and send b DTSC 'n or <br />