Laserfiche WebLink
I 4Pa988Bp lOr lyye�rfT�N - <br /> I {Form designedfor use on e1if9(12 prlch)tyl}~ -^d'- Xs y �` <br /> �r} NON-HAZARDOUS 1 Generators US EPA ID N Manifest bot No 2 Page 1 <br /> E WASTE MANIFEST of 1 <br /> i 3 Generalor s Name and!shading Address <br /> ` cheveron <br /> lodi , ca hwy 12 att •tim <br /> 1 4 Generators Phone( 209 ) 467-1006 <br /> 5 Transponer 1 Company Name 6 US EPA ID Number A Transporter's Phone <br /> Inviro tec n/a 434-0211 <br /> 7 Transponer 2 Company Name 8 US EPA ID Number B Transposers Phone <br /> r <br /> 9 Designated Facday Name and Site Aodress 10 US EPA ID Number C Facility s Phone <br /> inviro tec <br /> 2480 athens ave. <br /> li.ncol.n, ca 95648 n/a 434-0211 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit <br /> No Type Ouanuty 4vt/Vol <br /> a <br /> non haz waste water liquid//nos 001 tt <br /> 3oa dg <br /> �G b <br /> E <br /> N <br /> E <br /> R <br /> A c <br /> T <br /> Q <br /> t <br /> R <br /> � d <br /> I i I <br /> I <br /> D Ad,'tional nesc rp,enS'er Va eras Listed Abc e E Handl no Codes for L,'asles Lr51ed Above <br /> purge WATER FROM DRUMS � <br /> i <br /> 15 Special -ano,inc Instauc o^s end Aoo tioral Ir1l0r_a,0- <br /> 916-826-3803 <br /> eng/ troy w abco <br /> 1r GENERATOR S CERTIFICATrON I ce-i y re-r-- =cCSCr owe abo%e cr n�rranr eel e rnr< bte: IC'Coe al reC_L le IC— o rtporrrc groper d sposai of i doi, %las e <br /> Pnr ed/T%ped Name Signa L a rtso- ,lay vee <br /> r <br /> I <br /> T o 17 Transpcnar 1 nCMO reOCr b"]r cl heCC pt cl f,'rtE a s <br /> —�" <br /> Q f R fnteCTtiped Jae1`4q S{Cr-ttt 4ay[` ecr <br /> P r� s Irl t\ dk� -I _JJJJILrf�f� - fc � 7 � O <br /> O 18 Ira sperter 2 Ackne% ledgemer,of Receip of I,+,a'e Is <br /> R - <br /> T Prrrtec7ped Name Srgratare kaon rn Day Year <br /> E <br /> R <br /> 19 Disc epanq Ina cation Space <br /> F <br /> A <br /> C <br /> 1 <br /> 20 Facility Omer or Operator Cend cation of receipt o'r aste materials cove zo b� Iters r-endest except as noted in Item 19 <br /> PrnntedTypedNar-)e Signature rsonfti pay rear <br /> BILL ARTAMENKO 16-10-2t <br /> Pnnled by J J KELLE R&ASSOCIATES INC 12-BLS-05 Rev 1219$ <br /> Neenah WI 5a957 4368 <br /> TRANSPORTER #1 <br />