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l ;I I 1013M I <br /> t^S <br /> (�� )7ypewrNer <br /> so jpg 1 w! 1� *r� ��u r t <br /> NON-HAZARDOUS 1 Generators US EPA ID No Mandest Doc No 2 Page 1 <br /> WASTE MANIFEST K'A �tp�l b1 1 <br /> 3 Generators Name and fading Address <br /> cheveron lode <br /> 12 hwy <br /> 4 Generators Phone( 2 0 9) 467-1006 a t t : t i m <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transporters Phone <br /> xnvzro tec n/a 434-0211 <br /> 7 Transporter2 Company Name 8 US EPA ID Number B Transporters Phone ; <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facdtty s Phone - <br /> YnvYro tec <br /> 2480 athens ave <br /> lincoln , ca 95648 n/a 434-0211 <br /> 11 waste Shipping Name and Description 12 Conla vers 13 14 A <br /> Total Unit <br /> No Type auantity WVVoI <br /> anon haz liquid haste 001 tt g - <br /> s <br /> waste water <br /> G b <br /> E s <br /> N <br /> E <br /> R <br /> A c <br /> T <br /> r O v <br /> R JO <br /> d _ <br /> y Y <br /> a� <br /> Y <br /> D Additional Descr p ions for Natenals Listed Above E Handling Codes for Vdasles Listed Above <br /> purge grater from tan}, <br /> 1 - <br /> I r <br /> 15 Special Handling Instrucliors and Additional In`orra on <br /> r emerg <br /> ahco troy w 916--826-3803 <br /> t <br /> 1,13 GENERATOR S CERTIFICATION i ce-nv the =ic detcnoca eoc�, - ",s-nanfc-i arc not= ec o r-dc ul gut i io-s or repen�g p otc c spe-a cf I-ala d,,s w8s e <br /> r <br /> Prirred rvped Nage — r -r Dav Yr <br /> RTI 17 Transporter 1/Acknowr edaeme-t of Peceip,of f,'a a,s Ir <br /> A PprledT}ped t aretoe <br /> NS raylo, de Iy^n' <br /> r7 � �-- <br /> OIS Transporter 2 Acenov ledgemept of Peceipl 01 Ata s jais <br /> T Pnn,ed/Tvpcd Na—,e i Si^yndture fforrh Day 1 car <br /> E <br /> R <br /> 19 Discrepancy Indica ion Space - <br /> F ; <br /> A <br /> C <br /> 7Y0 Fac lily Oh ner or Operator :e^rficaiion of receipl a't+aste malenals cove ed by this manifest except as noted in Lem 19 <br /> i <br /> — <br /> Pr nted/TNped Name is Iron h Dev Year <br /> BILL ARTAMENKO G <br /> Panted oY a JM57- ER s AssoclArEs INC 12-BLS-05 Rev 1 2198 <br /> Neenah 54957-0368 <br /> ORIGINAL — RETURN TO GENERATOR <br />