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sxNONE= <br />rof talifomi nmeMal Protection Agency <br />Irttrm;Appro ved OMk 2050-0039 (Expires 9-30-94) See Instructions on bock(o page 6. <br />Department of Toxic Substances Control <br />Plea <br />, <br />or Form designed for use on elite (12 -pitch) typewriter. ' <br />Sacramento; California <br />15. Special Handling Instructions and Additional Information 7—q p0�0 i ryq+p.q1 <br />587859 f C9 ! <br />Q <br />UNIFORM HAZARDOUS <br />1. Generators US EPA ID No. Manifest Document No. <br />2. Page 1 <br />Information in the shaded areas <br />is not required. by Federal law. <br />F <br />WASTE. MANIFEST <br />J <br />of <br />Q <br />packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable federal, state and international laws. <br />3. Generator's Name and Mailing Address <br />c ` Producers <br />U <br />P.O« BOX 56 Lo l <br />If I am a large quantity generator, 1 certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be' <br />C4 <br />economically practicable and that 1 have'selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future <br />4. Generator's Phcme. <br />M 334-3352 <br />C' <br />t� <br />00 <br />e� <br />threat to human health and the environment; OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best <br />5. Transporter l Company Name 6, US EPA ID Number <br />0? <br />waste management method that is available to me and that 1 can afford. <br />Safety K1een CorpI D WQ8?D <br />®yP <br />Q <br />Pr'pted/T ed Name <br />! <br />7. Transporter 2 Company Name 8. US EPA ID Number <br />- , <br />Month Aar <br />V <br />Z9. <br />Designated Facility Name and Site Address ji 10. US EPA ID Number <br />Z <br />o <br />17. Transporter 1 Acknowledgement of Receipt of Materials <br />Safety Kleen Corp .. 7-11 <br />iP968 <br />W <br />O <br />J <br />Printed/Typed Name. <br />5050 Salida Blvd r C T 0 <br />Day ar <br />W <br />U0 <br />Q95368 <br />V <br />Todd Valdez _ .. <br />V. <br />' 0 <br />1 <br />18. Transporter 2 Acknowledgement of Receipt of MaterialsUj <br />"` 12. Containers <br />11. US RIOT Description (including Proper Shipping Jame, Hazard Classy and ID Number) <br />13. Total <br />Quantify <br />14. Unit <br />Wt/Vol <br />Z <br />Signature` `' <br />Y ?..: No. <br />_ T e <br />sa. <br />O <br />B <br />a• WASTE COMBUSTIBLE LIQUID N.O.S. <br />19. Discrepancy Indication Space <br />N <br />E <br />(PETROLEUM NAPHTHA) NA19§3 PGIII Mow) (ERG#27) <br />f <br />ado <br />N <br />b 4 <br />co <br />E <br />1 <br />er or Operator Certification of receiptof hazardous materials <br />covered b this monifest except as noted in Item 19. <br />A� <br />A <br />T <br />[MtRcirne <br />Signature <br />S <br />00O <br />T <br />c• <br />Y <br />oe'R <br />w, <br />DO NOT WRITE BELOW THIS LINE. ; <br />DTSC 8022A (7/92) <br />EPA 8700-22 Yellow: GENERATOR RETAINS <br />H <br />Z <br />d• <br />w <br />V <br />LU <br />Z <br />n <br />'. <br />sxNONE= <br />Q <br />O <br />15. Special Handling Instructions and Additional Information 7—q p0�0 i ryq+p.q1 <br />587859 f C9 ! <br />Q <br />Z <br />F <br />SK DOT #A 585 <br />J <br />16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of the consignment are fully and accurately described above by proper shipping name and are classified, <br />Q <br />packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable federal, state and international laws. <br />U <br />If I am a large quantity generator, 1 certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be' <br />economically practicable and that 1 have'selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future <br />C' <br />t� <br />threat to human health and the environment; OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best <br />waste management method that is available to me and that 1 can afford. <br />®yP <br />Pr'pted/T ed Name <br />! <br />Signature <br />Month Aar <br />Z <br />r <br />17. Transporter 1 Acknowledgement of Receipt of Materials <br />W <br />O <br />a <br />N <br />Printed/Typed Name. <br />Signature <br />Day ar <br />W <br />U0 <br />s <br />Todd Valdez _ .. <br />V. <br />' 0 <br />1 <br />18. Transporter 2 Acknowledgement of Receipt of MaterialsUj <br />T <br />Printed/Typed Name <br />Signature` `' <br />Month Day Year <br />sa. <br />O <br />B <br />Uj <br />19. Discrepancy Indication Space <br />Q <br />V <br />F <br />A <br />Z <br />C <br />1 <br />er or Operator Certification of receiptof hazardous materials <br />covered b this monifest except as noted in Item 19. <br />T <br />[MtRcirne <br />Signature <br />Month Day Year . <br />Y <br />DO NOT WRITE BELOW THIS LINE. ; <br />DTSC 8022A (7/92) <br />EPA 8700-22 Yellow: GENERATOR RETAINS <br />