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mlo—Envfronrrrenral Pralxhan Agency <br /> �e-+d OMIi Na 2650-0039IEsplr.s q 30 99) See Instructions on back of page 6. 4aporwner,i of Twnc S.,bsronces Can <br /> prtht or in* Form designed for use on aJ,to f 12 pirchl typ.wvter 3aeramento Colsfornla <br /> NIFOIZM HAZARDOUS 1 Generators U5 EPA ID 110 faanifast Document No 2 Poge 1 =1n6rrna0*rL s1 ailed areas <br /> WASTE MANIFEST �r� aF Fedoras la++ <br /> 3 GsneSotprsTfO send a ng ddresses y3� +7 A. Sidle AbnlifoliiOcIcurn.MNvrti6ar <br /> �{ Z'} !k'a.U�u D r ••4/ L f `�; ,��8079869 <br /> r �S 20 s. stb�e el lD <br /> to4 Generator Phone { 1 ` _f► ` <br /> N J TranspaMar 1 Company Norma b US EPA]D Number C. Sial i bat a FD <br /> a D Trah q f ph nil <br /> o ECOLOGY CONTROL INDUSTRIES 1u9, +y � ' . San <br /> 7 Tranmporter 2 Company Naim B VS EPA 10 Nuinber L slate, <br /> 6n •`', Irpl{E ti+ti ,Z' . f <br /> U - <br /> 9 Oeifgnafad Facility!lama and Sill;nddr,,ss 10 u5 EPA!p 1Vam6er <br /> 3 Ftomlc Chemma! Corporation <br /> 2081 Bav Road r{ { <br />`, P� ` ©-324- 638 <br /> 12 Con[oiners 13 Total 14 Unlf <br />�1✓ 11 U�DOT 17oscrlphon(lncluding Proper Shloprng Nttrna,NozzA Ooss and ID Number) No T e Ouantl W001 1 Wesly Number <br /> Vz <br /> RaQ. WASTE GASOLINE MIXTURE, 3, sror. � <br /> U N 1203 PGi l DO011 D018 01011 TTbaZ0,o G EPAJ014er^' <br /> laloa1,Iza1s <br /> 04 N b State <br /> N <br /> co E <br /> R EPA/OrJtar <br /> A <br /> � c Stale <br /> S <br /> ca 0 <br /> � EPA/Ottisar <br /> r <br /> W d Stare <br /> EPA/Oth+r <br /> N <br /> Z �.AddlNonal l5.scriplsons{rrlrlateNaia Lrsrad Abe•,, - K Handhny Codas fat b+rosiu Voted Ahoy,, <br /> 0 PETROLEUM NYURocARSONS 70%.100% <br /> WALEEMd'S6= 94 G+ Sir rl �r ,',;} s7• 1r a��1 <br /> 11a: 4d <br /> b 15 Sprxral fiandling inslruclrans end Addrhana1 Information <br /> Wear appropriate protective clothing when handling. <br /> 24 Hour Emergency Telephone Number: q16—(e <br /> 24 hour Contact� 'o r <br /> DOT ERG#11 a) 128 <br /> V 16 GENERATORS CERTIFICATION I hereby d,,,,lora that fha conitnls of tJ+t,conslanm.rti art 4u[ly and aecurololy dacerlbed above by proper shipping nome and are:closAied peeked <br /> marked and 4a6a{ed and are In ell ra3pecrn Ip proper aondrl,on For uansporr br hlghraT according to oppkrable,nletnonoeol and naliond)go-ernmonr regula•fons <br /> If I an a large quoii0 goneraiar,i certify that I Ue•a a program Ir place to roduee fho voluma aria la+rely of—o•Ia genarated to the de¢raa 164va derermsnod ro ba eeonosmcally <br /> aw Practicable and deal thane-aleerad the pradleabla metfiad of krafsnant,stora0e,or drspofal cwtanlly available to me which minim zas rho presanl and FuWrc 16raat Ia Kaman Molds,, <br /> and 14 ar-Ironment OR IF I am a small quantlty genarafor I hose made a good faith afiarf to Inlmao my.wale gonetalron and solea Iho best rase,,management morhod i{ral is <br /> a available to me and r4vt[can afford t <br /> 0 PnnledlTy�e /""� 5�gnature Mont;} Day Y ar� <br /> V 4J l <br /> LLJ <br /> Z <br /> T 17 T s crier I Acknovled em,,tit of Receipt of Maranal <br /> r <br /> Prm ypadflVama SIQ r Monts Got ear <br /> jN <br /> R <br /> tJJ S 1 <br /> P <br /> Q0 roes r Ac]<no�lod em+nt of Rac,,1 t of MaWtals <br /> R Prtnied/Trpe amo SSgnafury Monif. Day Year <br /> h <br /> U19 Discrepancyfnjxotlon Space <br /> � F <br /> A l <br /> C <br /> 2p Fault O-ner or O eratar Cartlfteohan of.aces i o1 hazardous aralaria)s as+orad b this ant sl wk 1 of naiad rn baric[9 I <br /> T Prinlad/T ad Moma Slgnarure � Monts+ Oar <br /> DO NOT WRITE LOW THIS LINE <br /> ,.666Z 8dW <br /> DTSC 8022A 14/971 -bile TS133:111 TWdZ S � 6 <br /> EPA 8701_w? r Z C4 bC-6 ON <br />