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Form A pivielf, OMB No. 2050-0039 <br /> y { iei= of 0.. MaNfestTrackingNumpat JJ <br /> F nasi f,tnt er t 't e, Form [#.. :;#n_J for use t)ti elite { i2 %Ch} typo anti ;.} 2. Page t of 3. Emergency Response Phone <br /> i . Generator ID Number 1 ( g00} 42Is <br /> UNIFORM HAZARDOUS CAD 0 2 8 2 7 7 0 3 6 <br /> WASTE MANIFEST Ger. tdtea`s Silo Addross (if diflerant than mating address) <br /> 5, t enrr o : *:amn ;t�J ki Itn� Ods cess <br /> `,I oil_ l_ iwiVi dt: mfiIENTAL SERVICES <br /> lat),U S . SANIA F" AVE CA x0:2 1 <br /> v <br /> O iv1PTOP <br /> Gercrapts- nn; 3:1,0 886-3400 U11 1111 11 11111: >S. tt�RiDNurnbas <br /> 6: Trttn rr±' : '1 Ccntv>.;iy R54 <br /> CAD029277 .03 i <br /> WORLD QIL ENVIRONMENTAL SERVICES U ,. Er�AtDNuner <br /> 7 : Tronspoticr Z Con #; y ± na <br /> U.S. FPA ID Number <br /> i;, 2 c..�,r} ;.^.si F ct ,hf t�alre nt±d St� Addrass <br /> ASBURY ENVIRONMENTAL SERVICE CERES CAL, C? 0 0 3 9 3 E33 0 <br /> 1820 MORGAN RD- CA 95358 <br /> CERES <br /> Fndlity`sPhone: it R41j;A1 -1A7 . io. Containers 1i . Total 12, Unit 13. WastaCodes <br /> 9a 9b, U.S. DOT DaMipGon {including Proper Shipping Name, Hazard Class, ±D Number, No Type quantity WtlVoi• <br /> Nhi and Packing Group (if any)} �1 <br /> G i <br /> tNON- RCRA HA7.ARDOUS WASTE . LIQUID (USED OIL / MIXED OIL) <br /> 0 01 T T r{ C1� G <br /> z 2 : <br /> LULU <br /> cs <br /> 31 wo <br /> I <br /> EMERGENCY CONTACT : CHENITREC ;1800-4249300 WOES TERt ilta =-:i )' P �,L7F " ATF E Eit3t� t;i_ ,P, U' ECTi:' f EGU Pf=i '� P11 <br /> EMERGEI # CY CONI"ACT CHEMTREC 800- 424-930() TRUCK is . Fpow <br /> bo y a pr per P. ackaged, . <br /> # r..t , t govarnmantai ragulaGo s. If export shipment and t am the Primary <br /> 15. GENERATOR'SIOFFEROR'S CERT1FtCATION : I hereby den±aro 1}tattha contents of this consgn nentae fully and ib u +!4 ^ r?o above b t? a shi n'ng ^ane, and era odes`-iGptt, P <br /> marked and labaledtplacarded. and ase to all t"P"'; in ProiI rnodltion for transport according o app6cabta e e rt- Jf quant ty <br /> Exporter, l carCfy <br /> that the contents of INS consignment conform to he terms a` the attached Ett'ne IV <,y Ycgr <br /> I certify that IN waste m{mm.za'ion statoment identified In 40 CFR 2B2.2i(a) {if I am a t ±y7 y+ua t 4 nstu } do J <br /> r _ .__ _ <br /> Part of ant taxa _ ..._ _ - _. _ �---- - —_ <br /> an.r7 CLI� 'PwIww + wVVV <br /> Exportfrorr U.S. y <br /> . ,. t ai3 . _,± t �. , ,, s Imcdrt to U S' ? ;;€r , U .S : <br /> VIVW <br /> w t r . Transporter AcRA0 ladgmant of Receipt of Meter ais <br /> Pt tipr ;tn, i Pontc yTyped Nano t3 `r <br /> },ionih Day Year <br /> a f t t C `EI ahue <br /> rnZ'S "Tyfa3NTreespo° e- 1Pir:ed: ame , I <br /> 1— <br /> 18. D I Vej`wa� ct' 1 Foil Re!ecUon <br /> Type Residue �._.� Pa?riat fteiacl,on <br /> 33 . Ciscrepa Ircticatian Space Quantity <br /> UIS, EPA I'1 JM?4 !: <br /> U IP <br /> Month Day Year <br /> tai. Fain r':: <br /> OL <br /> 4. �+ _. S':�. .. .ur- a r,itemate PaaiiCy {r:: Generatarj <br /> f� •. �. t"az:>. dvUS yti aStu Re(F%/+ }rtai?a�air:Ci}t }r1UE7tad t.;tytUJ { .e., �Ut$Ce iJEh3tardGlJS '.VaSte treetmenE, dtspasai and CBC}'dt't,t 4yStama) <br /> 11 HIM <br /> f17 5 . <br /> t.0 <br /> _.. - -- -- sw.rue <br /> !rr<i t)ar yom <br /> /^ C esiy <br /> '1'ed F aci&p Dmry or Ope. atc:r:IV 4 <br /> ( erti5aa4 a:± of receipt ei hazardous materiaFS cea'err d t=e tr-an .Ri,:rxcapt as n�ecE in ila:e <br /> EI=:; nur; 5700 21Re:' =3 .05) E 'revtous rru±t.�, ,� a; � i <br />