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A Ptssss gp�6rtEpr <br /> {Fam +etline o <br /> NON-HAZARDOUS l Generators US EPA ID No Manifest Doc No 2 Page 1 �- <br /> WASTE MANIFEST n/a 100001 1 o1 1 <br /> 3 Generators Name and Ma+hng Address ry, <br /> CHEVERON , LOD1 <br /> HWY 12 <br /> 4 Generators Phone( 209 ) 467-1006 _ <br /> 5 Transporter l Company Name f) US EPA ID Number A Transporters Phone <br /> znviro tec n/a 434-0211 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number B Transporters Phone <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility s Phone f <br /> snviro tec <br /> 2480 athens ave n/a 434 -0211 ,r <br /> lzncoln, ca 95648 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit <br /> No Type Quantity WWol , <br /> a a <br /> non haz 1,Taste liquid nos 001 tt g aw <br /> waste water <br /> G b s x <br /> N <br /> R <br /> A c <br /> wi <br /> T thh <br /> O <br /> R <br /> d <br /> r <br /> D Aad tional Descr pions for IJa,era's Lrs ed Above E HardlIng Codes for U\'csles Listed Abo,e <br /> rr <br /> I - <br /> Uurge water <br /> 15 Sp2�1a1 Handing Inslruc.cns and Addi ional ln'orrraucn I' <br /> emerq TROY 916--826-3803 <br /> if) GENERATOR S CERTIFICATION 1 Ce-'y the rtrrE c'<oast Itiec Dc%e cr s ricr fes Gre not s,b,eCt 10 tede el oegJla iC15 for apo-iry proper d sposal of Nazeroc.s 1 c <br /> Pm,eaTyped Name jSrcn rferrti D: tear <br /> 3 eQ V L Li /hAl E LW <br /> RT 17 Transposer 1 Ac�no%Oecgemerl of Reccrp"of Ma,era's <br /> A Prin ed T'd�,a_Name Signal, e rfcq h Da ar <br /> ye <br /> 14 7 <br /> $P get <br /> R .13 Tra,sponer 2 Acknoi+leocement of Rece pt of Ma a's <br /> T Prrnlea,`Typed Name 5igrat re Nc-,m Day a ear <br /> E <br /> R <br /> 19 Discrepancy Indrealron Space <br /> F <br /> A <br /> C <br /> I <br /> I <br /> 20 Facdoy O ne or Operator Cerlrf,calron of rete pt o'was e materials covered by this manifest except as noted in Item 19 <br /> -r'nnTed, ed Name aiu Aaonrti ply )c r <br /> Pnnled by J s KELLER&ASSMATEs INC 12-BLS-CS Rev 12198 <br /> Neenah W154957-03&8 <br /> ORIGINAL - RETURN TO GENERATOR <br />