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Please print or type 17 <br /> J YA <br /> l (Form designed for use on elite(121)ltch)typewriter) <br /> E NON-HAZARDOUS 1 Generators US EPA ID No Manifest Doc No 2 Page 1 { <br /> WASTE MANIFEST n/a 0001 Of _ <br /> t <br /> 3 Generators Name and Matting Address <br /> cheveron att tim ;. <br /> i hvy12 / lodi , ca <br /> 4 Generator s Phone( 209 ) 467 1005 <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transposers Phone <br /> INVIEO TEC NIA 43340211 <br /> 7 Transposer 2 Company Name 8 US EPA 10 Number 8 Transporters Phone <br /> 9 Des�gra,ed Fac111ty Name and Site Address 10 US EPA 0 Number C Facility s Phone <br /> inviro tec <br /> 2480 athens ave. <br /> lincoln, ca 95648 n/a 4340211 <br /> 11 Waste Shipping Name and Descnpt cn 12 Containers 13 14 <br /> Total Und <br /> No Type Ojan,lty lwtfvol <br /> a <br /> non haz waste liquid nos 001 tt ��� g <br /> ]waste water <br /> G b <br /> E <br /> N <br /> E <br /> R <br /> A c <br /> T <br /> 0 <br /> R <br /> d <br /> D Aed dcnal Descrip ions for Mare ia's Listed Above E Ha'idlrng Codes'or wastes Lis'ed Abo%e <br /> a] purge water from tank. <br /> 15 Special Hancling Instructions and rdoiliondl info rr. on <br /> ems abco troy w. 916 826--3903 <br /> 16 GENERATOR S CERTIFICATION 'ce ti t e nt cit s zest,_-c cbn c C- '=—a'i are nit=,` lc'ece nl eCLla1,C^s or eporling proper c,sposa et I-,.zaTcois was e <br /> Prm,edfTtped .'dme S qna Ie ! r } Cay year <br /> T�� 7 T g ooner 1 AcKnc+vied e nen of Receipt of t is E ,.s <br /> A I �Prli, _c Tvped Nam. S g^=} e �r n cat wear <br /> N <br /> P — - <br /> 11 18 T ransponc,2 4C1noti,1LcgEment f Recelpof Male --is <br /> R <br /> E Pier reo'Tvped Narne i S gratjre = r ;�r, pay yea, <br /> R (/ <br /> 19 D screpancy Indlcas,on Space <br /> F <br /> A <br /> C <br /> I <br /> U 20 Faclh,y 0%%net or Opera,er Cerit,catior or receipt o'1,asre materials covered by this man lest except as noted m qem 19 <br /> PrmledlTyped N,me Sgnattre � 11 ti Daav year <br /> Prnned by J KELLE R 8 ASSDClATES INC <br /> Neenah 12-BLS-05 REV 12/98 <br /> W1 54957 0368 <br /> TRANSPORTER #E1 <br />