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NON-HAZARDOUS 1.Generator ID Number 2.Page 1 of S.Emergency Response Phone 4.Waste Tracking Number <br /> WASTE MANIFEST 7 ^09-721-2038 1111-147364 <br /> 6.Genomfor's Name and Mauhg Addrasa Generator's Ehle Address Of dufarent then mailing-Wess) <br /> CCT STOCK.TON RAILYARD <br /> 1645 CHEROKEE ROAD <br /> STOCKTON.CA <br /> Generator's Phone: 91)5-366-0632 <br /> S.Transporter 1 Company Nam@ U.S.EPA ID Nrmrber <br /> ENVIRONNIENTAL LO ISISTICS.INC -AF?U4J1?'d47R <br /> 7.Tmmporter2 Company Name U.S.EPA ID Number <br /> 8.D�W"AaRjAPNM —ES-INC U.S.EPA ID Number <br /> 180 VJ.IVIONTE AVE Cl;r_2rft-?quajags <br /> RiFLTO.i,.A 9,316 <br /> u09_-i x'012 <br /> Fad a Phone: <br /> 9.Waste Shi 10'C011t9°'era 11.Totes 12 Ural <br /> Aping Name and Descdpibn ({N(o� Type O=ft wwol, <br /> 1. NOM F9.ZARDOl.1S MJASrF SC LiC; 1 1 DI:4 1, <br /> 2 NODJ H1t?J R,70US l^,r.4`T1 1-IQrJ?D 1 V {'ttn C <br /> 4. <br /> 13. Spades Handing instnktlornrepnd net In Drina n <br /> 081)SOIL it 17 S ',.'s?•(! lrrzl?i t?f2.ifiTt tri !r•1�Ja47:i 3-1 <br /> @ILL l-():TRC' <br /> r i <br /> 14.GENERATO11%CERTIFICAMON:I oedlty The materials deaodbed above on Ude manket are not subject to federal regula Wrung proper disposal of Hazardous Waste. { <br /> Generalor'afO moro PftadTyped Nama ( (j S4� y <br /> /1\ V - <br /> ib Irdemationai 9t rnonts Import to US. ❑Export ire.U.S. Port of entrylexh: <br /> TransWer Signatime for eVorls on a lm*o U.S: <br /> 10,Tranapoder Ardmawfodgment of Recafpt of Materiels <br /> Transporter 1 PrInla Typed Name Sigaalu Y <br /> C.t?21 G d2 <br /> Transpoder 2 PriMeffryped Name Signature Month Day Year <br /> 17.Discrepancy <br /> ❑Type 17a.DD,��,ccrepanny Inc�oa Spada ❑Resits ❑Partial Ro*aon El Full Raccoon <br /> I Cr! veceft D:tYtirrtS ./too f <br /> 10) rec e t '---P Q Mari est Reference Number: <br /> 174,AOemate Facility(or Generator) U.S.EPA ID Number <br /> a FadEtys Phone: <br /> 17a SIgW=of Alternate Faci11y(or Generator) Month Day Y�r <br /> 10.Dasigmled Nary Omer or arator.CerU0callon o1 recilpt of maledals covered by the manifest exoapt as noted In Item 17a <br /> PdnteUrypedName Slgnethae Monnth or <br /> ZN& <br /> ar 5DESIGNATED FACILITY TO GENERATOR <br /> 169-BLC-0 5 11977(Rev: O6) <br />