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1 - - <br /> �lease prirnartype <br /> (F.designed for use on elite(t 2-pitch)typewriter t <br />' NON-HAZARDOUS 1 Generator's US EPA ID No Manifest Doc No 2 Page 1 <br /> WASTE MANIFEST n a 0001 11 of <br /> 3 Generator's Name and Mailing Address <br /> chevezon Lodz <br /> wx hwy 12 , <br /> 4 Generator's Phone( 209) 467-1006 tim <br /> °l 5 Transporter 1 Company Name 6 US EPA ID Number A Transporter's Phone a <br /> i-i A a <br /> thrifty rooter n a 673-1923 Lr� <br /> } c 7 Transporter 2 Company Name 8 US EPA ID Number 6 Transporter's Phone <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility's Phone + <br /> inv>_ro tec <br /> t <br /> 2480 athen ave t <br /> lincoln, ca 95648 n/a 434-021113 —T4 <br /> s <br />' 11 Waste Shipping Name and Description 12 Containers Total Unit h`i <br /> No I Type Quantity WWoI " to <br /> a non haz waste liquid nos 001 t <br /> waste wateer , -trig <br /> a' G <br /> ' E r' <br /> N <br /> E Il <br /> �W4 R <br /> T c ba <br /> sk� O <br />'PqR At, <br /> t� <br /> d <br /> SLA Akr <br /> ri <br />'^ D Additional Descriptions for Materials Listed Above E Handling Codes for Wastes Listed Above e <br /> t"t purge water from tank 'rw <br /> 15 Special Handling Instructions and Additional Information P <br /> emg abco 916 B26-3803 <br /> troy w. <br /> C�M <br /> 16 GENERATOR'S CERTIFICATION I certify the materials described above on this mandest are not subject to federal regulations for reporting proper disposal of Hazardous Weste <br /> Pnntedrryped Name Signature Y ref i <br /> � Month Day Year <br /> rt T 17 Tran a_Acknowtedg of Matenals - ?' <br /> A Pnnted/T Bgj;Xa� 40wv QaV Year n <br />'�4 p <br /> O 18 Transporter 2 Acknowledgement of Receipt 6f Materials 3, <br /> T Pnnted/Typed Name Signature Monro Day Year ' <br /> R <br /> 19 Discrepancy Indication Space ; <br /> V -'a <br /> F -�I <br /> r A <br /> C <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> v <br /> Y 5 14�� <br /> Pnntedrryped Name Si <br /> M ar <br /> BILL ARTAMENKO <br /> Primed by J J KELLER 8ASSOCIATES INC 12-BLS-05 Rev 121/98 <br /> Neenah WI 54957-03W ORIGINAL- RETURN TO GENERATOR <br />