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I <br /> State o!Co"omfo--fzMronmaaaF PraMehan Age <br /> ran"Approved OA1d No 2aiD0039(Expires 9-.s Soo Instrl.1010nS on back of pages 6 Deportraerrt of Toxk SubdQM- <br /> Jslease P4V or IYP+ form detlprud for use on este(l2pottr)rypewrdor Sacramento,Calvfama <br /> UNIFORM HAZARDOUS 1 [�erseralor r U5 EPA ID Na Mansions Document No 2 Raya 1 Is fnof required by federal at taw <br /> s <br /> WASTE MANIFEST C A L +��' O I a 0 � rl 101 S 7 1 i of <br /> 3 Oa wrator's Nqme and Malllna Address A State Msrs*mttv'nran►u r <br /> ion OARPETRO, INC. <br /> C4 '34.510 EL OCAMINO CERES, CA 95307 s State Generator's ID <br />' 4 Generator's Phone ( ) <br /> 53Z-0071 - -111 111111, 11 11 <br /> 4 Transporter 1 Company Nome 6 US ERA 10 Nvmber C State Trprttpor'ter s JD <br /> op �13 <br />' ALLIED PETROLEUM C1 Al �j 0101011111 2f Ij 4 D Trnnsportfarr Pl,ene (209) 576-8500 <br /> 7 J Ulf <br /> 7 TrantpDAer 2 Company Ngme 8 US EPA Id Number E State TnmsparFe:s IQ <br /> ! I F Trarupotter's Phare <br /> z9 Devynated Focolay Mame Tand S s !10 US f P lD Number G 5lafer*Favlrly'sry D <br /> Lr <br /> A If V 8131116161712181 <br /> cr) 13331 N HWY 33 � H FaaLty t Phone <br /> PATTERSON CA 95363 C1 AlDj 018, 31 1' 61 61 71 2 B 800 874-4444 <br /> z l I US DOT Descrrptron(including Proper Shipping Name, Hazard Class and ID Numbar) 12 CoMamers13 7oraJ 14 Unit <br /> Na T Civonhty Wt/vol I Waste Numfaar <br /> j a /VSri <br /> Lfu ,1 /w1ZrL ttIle 4� /fClfL.r <br /> I I I r <br /> E 1 -I � EFA/QH»r <br /> a'S I61 <br /> r k state <br /> og � 6 <br /> i`trC r Ji ,:,c yt:Jincj t_,urpoekion (,ertrte- Wal. r tL)OV� laze+ltifled EPA/Other <br /> 1 9 R -(�+ 1 s1 -�rf� �r�ecrfl;ally Ide�Itlfkecl �y ref ere nee to the wlbt ma it s' <br /> A <br /> up T �. ' as were recycled Ire arcord3,nce Witt, state <br /> Q CCPR'_'61 5 and 23 r�r�y <br /> � R � c. d ail� �11�kr1 t� �F-'C❑ .��C, fPA/Other <br /> �u - I i <br /> a _ f� l�^ n, tae <br /> r2 ,t r "f tr+f1,'e with the orovtSior ';J;'` �,t;�� ub� rt [i � staf. <br /> PETROLEum RECYCLI'Ny COFIP 9A ! N I I I EPA,Other <br /> J Addrhonai Deunpftns for Materials Listed Above K Hondhng Co,$09 Wastes Listed Abase <br /> vl g Y y _ f----�tr <br /> u.r -- <br /> 4c kd <br /> 1.5 Special Handling Inrtrurnons and AddMwai Infarmehan <br /> PICK-UP AT, 749 E CHAaaTER WAY <br />' z USE APPROPRIATE PROTECTIVE GEAR STOCKTON, ;A <br /> LU DESIGNATED FACILITY EMERGENCY CONTACT # 600) 7C4-4444 <br /> a; GENERATOR EMERGENCY CONTACT # (209} 537-0771 <br />' 16 GENERATOR'S MTIMCAMN I hereby declare that the contents of this consignment are fully and occwrat*dencnbad above by proper shipping rsame and are cknufred <br /> Vpacked marked and labeled and are m all respech m proper condition for trarrport by highway according to opplKable rttfernerhonal and rxshonal government fogufahans <br /> If I am a large quartrMy goveroar I certify that I have a program in pioce to reduce the volume and roxitrly of waste gene"d fib the degree I haw determined to be <br /> lected the prachcoble rnefhod of treatment storage or daspcwl currently ovolfable to me which mmlm,zee the presern and future <br /> ecatsomKally prac+ncable and that I hes se <br /> threat fa human health and the ertvlroament OR rf I am a small gaanhty 4e I !love mode a ovod fav effort to minimae my Wa5m g",crhan and select the best <br /> omenl meMod that Is available to nw and that I can afford r' <br /> Signolure r f Month Day Year <br /> ;kL-& ,j , N_ tot <br /> Id <br />' Z T 17 r 1 AcknowkKiqernarto of Recerot of Materials <br /> f7 A Mo <br /> Printed/T f 11LU <br /> / S,grratsare ! Month1 Day Year <br /> i <br /> s 1/ <br /> syr o 18 Tra r 2 AcLnowledaernent f Recerot of Malenolt <br /> T Prwrhed/Typed Name I Signature Mon-h Day Y., <br />�O <br /> LU <br /> 0 1]f14repanry Indkat+on Soo.e <br /> � F <br /> U A <br /> I Cwvner or s mater cowre by this exec area+n i 19 f <br /> ' Prvregd/ Nome , Sty re c / .� MoreDay y9sr <br /> DO NOT WRITE BELOW THIS LINE <br /> uT5C S=A {Sar 941 <br /> �:�^e:; '1-rS CL-,P ren r,,.+FPaF'o , <br /> _EPA 11700-22 — - -- <br />