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•I ` , .. <br /> zgll� <br /> Shore of Cal} --aEavhronrw�ndd Protection Agency <br /> Form App d OMB No.2050-0039(Expires 9 3U94) See Instructions on back t, tge 6. Department of mxK Substances Control <br /> Pleau n,or Form dezi d for ase on eliro 12 rch der. \� Sacramento,California <br /> P^ type. Rne f Pi )�r R <br /> UNIFORMHAZARDOUS Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in he traded areas <br /> is not required 6y Federal law. <br /> WASTE MANIFEST Cl Al DI 91 81 11'41 51 91 91 3 51 6 of 1 CA93T1 M <br /> 3. Generator's Name and Mailing Address A. Slat Ma fes?Dar me ht Non:bi <br /> li ATTN: MICK HARDIN <br /> h ATCHISON, TOPEKA AND SANTA FE RAILWAY CO. t <br /> I n 740 EAST CARNEGIE DR. SITET DIAMOND & E WORTH------ -- — <br /> I. USAN QgNARDINO, CA 92408 STOCKTON, CA s Siam Ge"e oter's ID <br /> h�q 4. aerators one ( 9 386 — 4081 �l�i i—J <br /> 8 5. Transporter I Company Name 6. US EPA ID Number C St T'm,porfer s ID, <br /> 6 M`5 VA10 AJ�G <br /> LoQ 7. Transporter 2 Company Name 8. US EPA ID Number - E. State Transporter's IC <br /> LnV <br /> M } I� F Tr p rter'i Pao <br /> N— 9. DesigrhMed Facility Name and Site Address 10. US EPA ID Number G. Store F c lity'SiD <br /> MO PETROLEUM RECYCLING CORP. 1 J-1--' -LL-1 1 <br /> �LL 13331 N. HWY 33 ". ✓s Phone _ ____ <br /> `Ma PATTERSON CA 95363 <br /> �v s 12. Containers 13- Total 14. U'!' ---� <br /> Z 11. US DOT Description(indudag Proper Shipping Name,Hazard Class,and ID Number) No. Type Quant Wt,Vol i. Wars N.';E, <br /> PETROLEUM HYDROCARBON CONTAMINATED WATERS ° <br /> 3 G NON—RCRA HAZARDOUS WASTE LIQUID --- -- <br /> Ci E <br /> D M G E A/a,h tG <br /> E <br /> V R FA/C„_ . <br /> 0 7 C. s; <br /> at <br /> O <br /> R <br /> w I <br /> Z <br /> d. <br /> w <br /> Z _ <br /> T— <br /> O '.or 'ed Abme I K. Hnndl'ng Codes fo-WasiEs' ed Ab { <br /> 'laj 'T <br /> Z <br /> Z <br /> 15. Special Handling Instructors and Additional Information 24 HR. FM RFl:Nr'V V0f9TAC <br /> Q <br /> Z 24 HR. EMERGENCY PHONE <br /> w <br /> CE OE JOB: <br /> 16. GENERATOR'S CER71FICATION: I hereby declare that the contenh of the consignment are fully and accurately described above by proper shipping name and are classified, <br /> Qpacked,marked,and labeled,and are in all respells le proper condition for transport by highway according M applicable federal,state and international laws. <br /> V <br /> If I am a large quantity generator, I certify that I have a program in ploce to reduce the volume and toxicity of waste generated to the degree I have determined to be <br /> J economically practicable and that I have selected the practicable method of treatment,storage,or disposal cuneMly available b me which minimizes the present and future <br /> Nthreat to human health and the environment;OR, 8 I am a small quantity generator, I have made a good faith effort to minimize my waste generation and elect the best <br /> waste..,gement method that is available to me and that I can afford. <br /> Q Painted/Typed F Signature Month Day Year <br /> U <br /> Z T 17. Tram,parter 1 A,knowled amens of Recei t of Materials <br /> NPrinted/T Sig N ` Month Day Year <br /> ° 18. Trans r 2 Acknowled emmf of Recei t of 41, <br /> W i Printed/Typed Name sigraNre Month Day Year <br /> LL e <br /> O <br /> W 19. Discrepanzy Indication Space <br /> LA <br /> Q F <br /> V A <br /> 1 <br /> l <br /> I F20. F,,:,Iily Owner or Opema,Certification of recei t�h...,d.sterials covered by this manifest escaf as noted in Item 19. <br /> T I Printed/Typed Name Signature Month Day Year I <br /> Y h J11 <br /> I <br /> DO NOT WRITE BELOW THIS LINE. <br /> X13 <br /> D:Sc 8022A f7/92I <br /> (PA 8IC'--27 - Yell., GENERATOR RETAINS <br />