Laserfiche WebLink
NON-HAZARDOUS 1.Generator'.US EPA ID No 2.Page 1 3.Document Number <br /> WASTE MANIFEST of , 6 511 <br /> 4.iGenerator's Name and Meiling Address <br /> rrontiu- 7rP'ast•r}w+�o� <br /> Ins Gard. 4A <br /> 7r",C4 9S304 <br /> Generator's Phone <br /> 5.Transporter Company Name 6. US EPA ID Number 7.Transporter Phone <br /> CLEARWATER ENVIRONMENTAL CAR000007013 510 476-1740 <br /> 8.Designated Facility Name and Site Address 9. US EPA ID Number 10.Facility's Phone <br /> ALVISO INDEPENDENT OIL <br /> 5002 ARCHER STREET <br /> ALVISO, CA 95002 <br /> E CAL000161743 (510)476-1740 <br /> E11.Waste Shipping Name and Dewription <br /> 12.Containers 13. 14, <br /> TotalUnit <br /> H a. No. T Ouenti WtNot <br /> T Non-Hazardous waste _�l c7UL <br /> b. <br /> tio>J- Hpzo-laotrswA —Solid D-Z (sdb P <br /> 15.Special Handling Instructions and Additional Information <br /> Handling Codes for Wastes Listed Above <br /> Wear PPE <br /> Emergency Contact <br /> (510)476-1740 <br /> Attn: Kirk Hayward <br /> 1e.GENERATOR'S CERTIFICATION: I certify the materials described above on this manifest are not subject to state or federal regulations for reporting Proper disposal of Hazardous Waste. <br /> r <br /> PrintedTjped Name Signature •� <br /> ` <br /> R <br /> y S! �� o repo o f Getied� a year <br /> 17.Transporter Acknowledgement of Receipt of Metertalb <br /> Printedrryped Name Signature <br /> / � 1/y1- - A jC /' / MWM Day year <br /> 18.Discrepancy Indication Spaced- <br /> 19.Facility Owner or Operator.Certification of receipt of waste materials covered by this manifest except as noted in Item,18. <br /> zure <br /> He S V e(Afar) � ��� Mon64 Day Year <br /> - IZ � 2j�gl <br /> ORIGINAL(Raturn to Generator) YELLOW—TSDFRetain Copy)py) FINK—TRANSPORTER COPY GOLDENROD—GENERATOR'S COPY <br />