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rR1r <br /> NON-HAZARDOUS I Generator s US EPA 1D No Documen�sNo 2 Page 1 <br /> WASTE MANIFEST °f <br /> 3 Generator's Name and Mailing Address 1 8-7,3 3 <br /> TIME OIL -- LOCKFORD <br /> 14rr000nn�EHIGHWAY 88 <br /> 4`LaehC6�l�fion {A ) E <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transporter's Phone i <br /> RECYCLINGEILTEIR SVS, INC.-NO (510) 670-9901 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number 8 Transporter is Phone <br /> Filter Recycling Services, Inc. C AD 8 8 2 4 4 4 4 8 1 - (909) 873-4141 <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility s Phone <br /> Filter Recycling Services, Inc y <br /> 180 W Monte Avenue (909) 421-2012 <br /> Rialto CA 92316 LC A D 9 8 2 4 4 4 4 8 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit s <br /> No Type Quanti Wt Vol t <br /> a NON HAZARDOUS WASTE LIQUID <br /> .0 �,,JWIQ 0 Gv 0 G <br /> b <br /> E NON HAZARDOUS WASTE SOLID <br /> E <br /> N <br /> R fl7 Qoo P <br /> A C � <br /> T <br /> 0 <br /> R <br /> d <br /> D Additional Descriptions for Materials tasted Above E Handling Codes for Wastes Listed Above <br /> 11A)PURGE WATER r <br /> 11B)SOIL <br /> 15 Special Handling Instructions and Additional Information <br /> I <br /> Wear appropriate protective clothing <br /> 24 Hour Emergency Response # (909) 721--2038 BILL TOP SECOR INTI" <br /> S � <br /> 16 GENERATOR'S CERTIFICATION I certify the materials described above on this manifest are not subject fo federal regulations for reporting proper disposal of Hazardous Waste a <br /> Printed/Typed N me Signature _;;:IF Month Day Year + <br /> _j <br /> (010 <br /> TR 17 Transporter 1 Acknowledgement c <br /> of Receipt of Materials ; <br /> Nnted sped Name Sign atu a Month Do Year <br /> i 5 0 0 <br />■ p 18 Transporter 2 Ackn ledgement of Receipt of Materials <br /> TPrint Typed Name Signa Doth Do Y <br /> R /j A <br /> 19 Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> Panted/Ty me Signature Month Day Year <br /> a t <br /> /Nd$6 I I /X10 Ifl <br /> ���� �� � ORIGINAL RETURN TO GENERATOf2 "` <br />