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------- ---- ------- ---- -- <br /> State <br /> Slate of California—Environmental Protection Agency - <br /> Form Approved OMB No.2050-0039(Expires 9-30-99) ` See Instructions on back ae 6. Department of Toxic SuW maes Control <br /> Please print or type. Form designad'/or use on elite f I9-pitch rater. Sacramento,C4farnia <br /> 1. Gtme,c is U$EPA ID No. ,Manifest Document No. 2. Page I Information in the shaded areas <br /> Is UNIFORM HAZARDOUS Y is not required by Federal law. <br /> WASTE MANIFEST p q iT .r d:- 2 3 aft- <br /> 3. Generator's Name and Mailing Address A. State Manifest Document Number <br /> ODI AIRPORT MAINTENANCE CORP. 9852613 <br /> B State G ne obis ID <br /> o .O. $0`( B. pCAMF'0Y CA 95220 _ t ' <br /> W1 A. Generators Phone 2019 1 .. <br /> N 5. Transporter I Company Name 6. US EPA ID Number C Smta Tromp "'ID yKiC ` <br /> OF 4OR CAL OIL C: AD 9 92 4 17 2 55D. Transpci Phone w ii <br /> o (209)6F7 6S4s <br /> 0 <br /> W 7, Transporter 2 Company Name B. US EPA ID Number E State Transporters ID <br /> F.Transporter's.Phare <br /> .ti <br /> U <br /> 9. Designated Facility Name and Site Address 10. Us EPA ID Number G, State Fa<ibtys ID <br /> d INDUSTRIAL SERVICE OIL I.O. <br /> 1Z 1700 S. SOTO ST. H. Facility',Phone <br /> 'ODS ANGELES, CA. 900123 _ A 3 9 S' -1 <br /> LL <br /> 12. Containers 13. Total le. Unit - <br /> la.! 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No. Type Ouantity Wt/Vol 1, Waste Number <br /> 5rara�" <br /> �= OA—RCRA HAZARDOUS WASTE LIQUID L'-3 <br /> 13 G (WATER. & SLUDGE) C? T i. EPA/other <br /> a N <br /> Is. ate <br /> erne E EPA/Other <br /> v R <br /> A c State <br /> o T <br /> m O EPA/Other, <br /> R <br /> ce Stat. <br /> d <br /> Z - EPA/Other <br /> U <br /> ea t t Bove K. Handling Codes For Wastes Usted Above <br /> Z b. <br /> uif}sT:' <br /> d. <br /> Z 15. Special Handling Instructions and Additional Information <br /> O <br /> a PPRO "TATE PROTECTIVE CLOTHING SITE: <br /> Z EMEF.'GENCY CONTAf_T: 0'2091541-9145" HWY. 99 '< TIHANT <br /> = Ld <br /> .R.G. 171 <br /> r <br /> ERAT00.'S CERi1FICATION: I hereby declare that the contents eF this consignment are fully and accurate)y described above by proper ship Ing name and are classified,packed, <br /> Ved,and labeled,and are in all respects in proper condition For transport by highway according to applicable inh rnmional and actionaPgavernment regulations. <br /> m a large quontiy generator, certify that I have a programin place to reduce the volumeand toxicity of waste generated ro rhe degree have determined to be human icaltYticable and IhatI have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human healththe environment;OR,iF I am a smallquantity generator,I have made a good faith effort ro minimize my waste generation and select the best waste manogemant method that is <br /> aclable to me and that I can afford. <br /> Signatur [[[ Month Day Year <br /> yped Nartp r 's orter 1 Acbnowled ement of Receipt of Materials f % I <br /> 0.r /� / Signature Month Day^ xear <br /> w A Printed/Typed Name / _ i y ./.�1.G'r.— I <br /> w i.„ �f 1 1 r- 7A <br /> P <br /> kTE, 1111. Trans ower 2 Acknow ed errantof Recei tof Ma rials Month Day Year <br /> OrintedRyped NameSignature'U .cra0anry Indication Space 's <br /> t <br /> Tuner or O orator Certification of recei t of hazardous materials cmerad b this manifest exce I ai noted in Ilam 19. Month Day Year <br /> 'JP1ame Signature <br /> ;�A1f DO NOT WRITE BELOW THIS LINE. <br /> Yet <br /> 2A ld/971 <br /> _22 i <br />