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Please rim ar type <br /> (Fano designed for use on elite(121xtdt)typewrtter) <br />' NON-HAZARDOUS ElGenerators US EPA ID No Manifest Doc No 2 Page1 <br /> WASTE MANIFEST /a 0001 lof 1 <br /> 3 Generator's Name and Mailing Address <br /> r, cheveron " <br /> lodi ,ca <br /> c 4 Generators Phone( 209 ) 467-1006 <br /> sy <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transporters Phone <br /> thrifty rooter n a 673-8201 <br /> 7 Transporter 2 Company Name 8 US Number ransporter's Phone <br /> � rtEPA ID NbB Tx <br /> u <br /> rC 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility s Phone <br /> 1 a <br /> inviro tec <br /> t 2480 athens aver <br /> ' <br /> lincoln, ca 95648 ,4� <br /> n a - s <br /> 14 <br /> 11 Waste Shipping Name and Description 12 Containers Total Una , <br /> No Type Quanbty Wt/vol -9i} <br /> f � r <br /> a <br /> non haz waste liquid <br />' waste water 001 tt <br /> G b <br /> * E �ws <br /> 1 N e <br /> it E <br /> r R <br /> h A c <br /> "v T u <br /> O <br /> xs R <br /> F d Lry <br /> 'p c <br /> W: <br />' D Additional Descriptions for Materials Listed Above E Handling Codes for Wastes Listed Above r <br /> 5 <br /> v purge water from tank <br /> R _ <br /> 1 igt 5 <br /> 15 Special Handling Instructions and Additional Information <br /> emerg contact; ABCO TROY W. 916-826-3803 <br /> i 3 T i <br /> Ms, 16 GENERATOR'S CERTIFICATION I certify the materials described above on this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste , <br /> Pnntedrryped Name Signature Month Day Year r <br /> 1 <br /> TR 17 Transporter 1 Acknowledgement of Receipt of Materials �w <br />' A Pnntedrryped Namej Si n tur Month Day Year <br /> S :L I(. I.tlt r .� <br /> O18 Transporter 2 Acknowledgement of Receipt of Materials <br /> �u R t i <br /> r <br /> .� E PnMonth Day Name Signature Y Year <br /> Y <br /> R <br /> 19 Discrepancy Indication Space � <br /> F ` <br /> A <br /> 1 C <br /> 20 Facility owner or Operator Certification of receipt of waste materials covered by this manifest except as rioted m Item ii9 <br /> p.� r <br /> r <br /> Y Pnntedrryped Name Signatu� Month Day Year <br /> BILI., ARTAMENKO � _�'��� �- �i �'a"�'''��� 9 22 2k <br />' PnntedbyJ J KELLER&ASSOCIATES iNC <br /> Neenah WI 54957-0368 12-BLS-C6 Rev �2/98 <br /> ORIGINAL- RETURN TO GENERATOR <br />