Laserfiche WebLink
06/17/2011 12: 34 1-209-368-1851 JIM THORPE OIL INC PAGE 01/01 <br /> _ 1 <br /> Ploam print or l e.(form desigrod for use on ellla i2• itch vvflw.' Fam OMB Wo.20Sb 403A <br /> UNIFORM HA2ARDOU5 1.Gernrrabr ID Numdor 1'. <br /> Page 1 of <br /> 3.Elmrger>vY Rwpanla Pha a <br /> WASI�MANIFEST C A O U Q 8.`� E T 2t1'S�BT�$�7 FLE <br /> acnarolcrt Name r A�.I.EY WASTE L .WCe g ( dt o ent n meUnD waren <br /> POBOX 340 (DECEIVE® <br /> DELK CA DWIS 20$-0"7-M57 <br /> Generator's •. ,s '.� ' <br /> U,8.ERA 10 s amber <br /> AIMR M VALLEY WASTE OIL CAL00082T878 <br /> 7.Trenxponer0ornpwrytML-5-EPAIONMENTAL HEALTH <br /> 8,DaS ted Fedaty Name and Sita Amfeas U,S.EFA ID Nwnbor <br /> DK4XXON <br /> 7300 CHEVRON WAY CAT08002.2B07 <br /> P», 1 CC�t 9�0 Tg71-BIS. <br /> 9C.US OOT Deacdpsbn dudl Proper ShlpP�+9 4eme,He��Clef r l�flul+ba se. 10.Canlalnera It Tcw 12.urh r n9 13.Yibmte Cams <br /> KM and F'eClQfig Group(b anyl) - Na Type QB�IM <br /> o ' NON-RICRA KMARDOUS WASTIE LIQUID , �r:� 221 <br /> u�Eou#fact aa� ) o D 1 T T C <br /> LU z. <br /> a. <br /> 4. <br /> 1a, pntial Nandlrg 4'6lnrctlDM1SarrQ re ormeWn <br /> GLOVES <br /> FIROF LE DKONWI <br /> TRUCK S <br /> 15, G2NLftAYOR'9rOFFt:ftOR'S CERTIFICATION:f,r4mby dCC1Dre L47t 11n anlarM of tltis rxnaigrmerl srefcty amt amrtolNy deambed abme by the proper eh)ppl:rq none,uvi aro r4tu.Yad,lutk�gee, <br /> rtorlaed and lebeledlplacraded,and e:e h ail reaaecba In proper oorditbn for sahsmt acoat"b sap c&%Mer;avcw%I wid nafcr w goaeirmenel repuladorm.If expc+t stip,mwl W7d 1 em the phnary <br /> F�yorm,1�ry tnat ttM cantdnls olNls eo•xgrtmont anfarm m d,e tertre Df the aCec'red E?AAcsnoe�edgrrartt ofCa•+en. <br /> 1�y tt101 the waste ralnlm�edm s�hrnenl fderdlAed In A0 CFR Ztj2,y7le)(i I sm a Wrga q anL�y genersbr)d(D}Qf I am a emelt qua n8�.4o nonfat)b 1rve. <br /> r a P1nt@UTnmd Name <br /> J tmlwfl b U•S <br /> , ma ,tet rr�% orfs o Date �� <br /> Eg7ort Iron�,& Port of ---------- <br /> TrBnaxrlcr ' luro US.: <br /> LWL <br /> t7.hartsparfer+k>rtovlddQntortofRecdptofMatarae <br /> I Pd T&Td *Namo gqre oy ser <br /> ionsputar 2?MLwfTvXd Narao a ti <br /> 18.Dtxpapancy <br /> Sba-oisaapnney tnEra9an gFaco ❑ gear Ry ❑TM ❑4o�cu9 0 Patel RsoDn ❑FuU Re,'ectm <br /> Mlanl'd iter <br /> 18D-AiWmLeFully(Dr Cer aim) U.S.EPA'ID%maer <br /> � c <br /> V <br /> FBat�s Phone ' <br /> C3 t&.Rrat ce c atemete rodUry lwaenermar) Mardi Day Yest <br /> 19.Hazardous Waste Report Management Med'od Codec(ie.,codes for haratdtw w®ts traswent d ooeat Brad moping systems( <br /> 20.DeslgnsW aadIty Nm or Operator:OOTUry ton of mcolpt of esa»rdeus meterlsls c%wec by Q e marlfasl aim pt an r*w In hoot 1841 <br /> Pen o / naaro � Mandl Day rear <br /> EPA Pam 8700.27.(Rev,XS Previous edit are obsolete TRAN!kRTERS 46PY <br />