Laserfiche WebLink
UNIFOOM HAZARDOUS 1 Qeneramr's US EPA IO No Manifest 2 Faye 7 tnforrnatW rn the shaded areae' r <br /> WASTE MANIFEST Dooumont No <br /> of Is not required by Federal taw <br /> 3 Geheralor'a Npms and l4tading Addrtl�g �y <br /> X 78tattl�+l�aaftlit�Met�MWIVry, <br /> Exxon U.S:A. Station # 7-333r � ri ' . <br /> 70 P?O• e° hw rw"a ra4- <br /> 4 GOneralor$P X 44I5 Hotont Txv 77310-*441*� ; <br /> hone t �1Q 246-8185 ,��@@''` ,Qr1 <br /> 6 tnnaporter 1 Company Name 0 US EPA lD Number Q,M,Slasil 1t §i�igeflpd'y io t w <br /> Eriak ren, xnc: C A D O 0 9 416 6 3 9 2 !"" ' �`a , a H 1 „ zt393 <br /> 7 Transvorter 2 Company Name a US 917A tO Number E.`,$latt�irftfta �terA�d <br /> F,M Tr�t�spp►tyrM�t10ne' <br /> S Dealgnatod F4LOMly Name and Site Address 10 US EPA ID Number <br /> Gibson = M <br /> a Oil / Pilot Petroleum " <br /> 75 Se f <br /> & Port Blvdr !1 Fettn�tt r <br /> "redwood City. Cat: 94644 CAD 0 4 3 2 6 O 7 O 2 ;rt' <br /> I t VS DOT Deacr tips tinCfydlny p 12 CvMalners 18 Total 14 °I <br /> ra roper Shipping Name Nazprd Class,and Ib Number) Quantity Vnd Watrtt!!!da" <br /> Nd Type Wt/VV! <br /> a RQ Hazardous Waste Liquid N:O:S: stat e222 <br /> 0 <br /> N OM—E NA 9169 V018 O p 1, x T CPO IS <br /> EPA/Cather <br /> E b <br /> R State <br /> A <br /> T <br /> O Epyarvtf►tti! <br /> R v <br /> S v n n" <br /> PAi .fiat <br /> d <br /> state <br /> 1=f'ArOther <br /> a dittOnal0604NWJ0116 for Mi1tertela L18110411ti0" ;� s <br /> yy�yp handling s for iNsees Listed Above <br /> rg8>C 77/a r k a ° n e Y w b <br /> Diese3. 4-5% v <br /> 15 Special Hilindlrnp Inotructfons and Addrbonal Information <br /> Gloves ERG 31 2 �€ � Contact Name G� ,�MM� <br /> Site; 31Z& w ��)�MI trPb. # 1--800-992-•3647 Profile 10626 <br /> =Tcc� <br /> 113 <br /> GEMPATOR's CERWITICATION thereby d"targ that the contents of thry Consignment are fully And accurately deacrlbed above by propor shipping name <br /> and are ctasarfred pooked,markers and labeled,and are In atl resPoets 10 proper condition lot tfpnvoort by highway according to applrceble inlematlonal and <br /> natroaal government requtAtron§ <br /> If 1 am a large quantity geaorator.I cemly that I hav¢a Orogrem ort place to reduce the volume and toxicity of waste oonerated to the degree 1 hav4 determined <br /> to be 600nomicielly practicable and that I have selected the practicable mothod of treatment storaQo or dlspouel currerrity,ava8able to mo which minimizes the <br /> Present and future threat to human health and the envrfonmer4,OR.if I em a small Quantity generator I have made a 0004 felth effort to minimize my waste <br /> 0enerallo11 and eeleCt the best waste management method that is avarlppte to me and that(can afford <br /> RIMed/Typed Name I SrOnature Month pay Year <br /> d+ <br /> T 17 Transporter f Acknowledpoment of Reoorpt of Mater ala <br /> R <br /> N Prinloo/Typed Name Signature Month bay Year <br /> S — <br /> P18 Transporter sportef c nowle gement of ROCWpt oy Majeriars S' k>At2Lepd�el -7 <br /> £R Pnnledi yped Name <br /> Srgnatpro Monfh bay Yee` <br /> Ft <br /> ig Olecrepency Indicown Space <br /> F <br /> A <br /> G <br /> t <br /> L <br /> 11printed/Tyw <br /> 0 Facility Owner or Operator Cortificatlon of receipt of hazardous materials covered by this m$nrfest except as noted in Item tq <br /> r <br /> y Name 5rgnattire Month O4y Yoar <br /> Do NOt wflte Bellow This Une <br /> Provioua 041ttona are obsolete <br /> °ter C-EN:RATO� SF-NDS Ts h13, COPY TO DOHS WITHIN 30 DAYS <br /> To PO Box 400, Sacramento CA 458)2.4440 <br /> TOTAL P,01 <br />