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Please print or type <br /> [Form designed for use on elite(12-pitch)typewriter) <br /> NON-HAZARDOUS i Generator's US EPA ID No Manifest Doc No 2 Page i <br /> WASTE MANIFEST n a 00001 1 o 1 <br /> MIN 3 Generator's Name and Marling Address <br /> cheVeron <br /> hwy 12 <br /> " 4 Gengr6gjPnont(a 209) 467-1006 t1m <br />' 5 Transporter 1 Company Name 6 US EPA ID Number A Transporters Phone <br /> thrifty ooter n/a 673-8201 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number 6 Transporters Phone <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility's Phone <br /> a invlro tec <br /> k 2480 athens ave . <br /> lincaln, ca 95648 nZa 414-0211 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit <br /> No I Type Ouantrty WI/Vol r <br /> a <br /> non, haz waste liquid nos <br /> "t 220Q ga ' <br /> r <br /> waste water 001 <br /> y E b <br /> r N <br /> E <br /> } R <br /> A c <br /> T <br /> ' R <br /> d <br /> D Additional Descriptions for Materials Listed Above E Handling Codes for Wastes Listed Above <br /> purge water from tank <br /> 15 Special Handling Instructions and Additional Information <br /> IT emg // abco <br /> troy w. 916-826-3803 <br /> I 9 a <br /> 16 GENERATOR'S CERTIFICATION I cendy the mafenals descnbed above on this manifest are not subject to federal regulatlons for reporting proper disposal of Hazardous Waste <br /> Pnnted/Typed Name Signature Month Day )ear <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> A Printed/Typed Name Signature Month Day Year <br /> WNS BOB FETTY <br /> P <br /> R7nnted/Typed <br /> 16 Transporter 2 Acknowledgement of Receipt of Materials' T Name Signature Month Day Year <br /> E <br /> R <br /> 19 Discrepancy Indication Space <br /> I F <br /> A <br /> C <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest 'ept as noted in ite <br /> T <br /> Y <br /> Printed/Typed Name nature Month Da Year <br /> BILL ARTAMENKO <br /> I Pdnted by J J KELLER&ASSOCIATES INC 12-BIS-05 Rei 2f98 <br /> Neenah WI5495703fi8 ORIGINAL- RETURN TO GENERATOR <br />