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ry - D. Iron„spoI Com ny Name - 6. US EPA ID Number - <br />OR # or of o C AD 9 132. 4 17 2 55 <br />O <br />O i <br />7. Transporter 2 Company Name 8. US EPA ID Number <br />Q <br />V 9. Desi gated Facility Name and Site Address 10. US EPA ID Number <br />iQ NDU ?TRIAL SERVICE OIL CO. , <br />z 700 S. SOTO ST. <br />Cie <br />AN�EL.E � CA. 90023 A a 9 4 <br />t Special Handling Instructions and Additional Information <br />a PPROPR I ATE PR.OTEC:T I VE, CL.OTM I NCa <br />Z 'EMERGENCY CONTACT i ( 209) — 14J iUj <br />s <br />EE E. R. a. J'/t - -..- <br />16. GENERATOR'S CERTIFICATION: 1 hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, <br />Umarked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. ° <br />If I am a large quantity generator, 1 certify that I have a pro ram in place to reduce the volume and toxicity of waste generated to the degree I hove determined to he economically <br />V) practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present a ed future threat to human health <br />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 waste management method that is <br />Printed/Typed Name Signature- Month Day Year <br />Z <br />LU <br />(D <br />(� <br />1 <br />17. Transporter 1 Ac nowt gemenP of Receipt of,Materials <br />W <br />1 <br />A <br />N <br />Printed/Typed Name / Signature— _ — Month Day a ear <br />»✓ <br />I <br />S <br />r"g <br />Le <br />w <br />LZ 1 <br />O0 <br />18. Tromllrter 2 Acknowledgement of Receipt of Materials i <br />i <br />Printed/Typed NameSignature <br />Month Day Year <br />U.1 <br />N <br />R <br />V19. <br />Discrepancy Indication Space <br />Z <br />_ <br />F <br />p <br />, <br />C <br />1 <br />t <br />1 1 <br />20. Facility Owner or Operator Certification of receipt of hazardous materials covered k6is ma est ce t as noted in Item 19. <br />