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<br /> '10/27/2005 13:52 12099486F;72 BP/ARCO PAGE 04/04
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<br /> UNIFORM Generator's US EPA ID No. �'' '' Monihst'Ooawux.rno..':'. 2....Pagit 1.', ::fnfermalion'.le the shaded arae
<br /> HAZARDOUS
<br /> 4:1,
<br /> + 1 ' Jim y., trY1 is not regYFhr1 F�detaI I `;
<br /> WASTE MANIFEST
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<br /> 3. Generator's Name and Moiling Address ., ,�. : �;� { "Ifett,5D,ocutintenµNutlt "
<br /> ' SP TERMINAL M659 2100 NA"i ■Tltt3'BT +,,✓!li4.�11. ;' 1' •••,w r,.+�t au.. ..
<br /> 2700 IMSHZt1TG"rON SIXD STOCKTON, CA 93203 Q 8fei% fai''sIDw�f {�, t? �aAP'•
<br /> (CA 5203 ATTN: SCOTT KMOCH � k
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<br /> S. Transporter 1 Campany Nam; 6. US EPA lb Numberti G-:E ransparter�►D eselvetl j + " i 7,-g,
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<br /> 7, rensperkr Company ame A umber $iota run j
<br /> Et spnrsor's ID fpeserved t.. t•
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<br /> 9. Designated Facility Nam —N =F.dl
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<br /> _. rp by a and Site Address 10. US EPA 1D Number s,fD7M1C SNVLI,Otilt4138 "�,L TSCEI�ip1,0AISR '2081 BAT ROAD x�,;p ., ;tfy �, eer '" -,'t?I
<br /> a SAXT PALO "TO, CA 99:303 :
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<br /> r U 11. US DOT Daxcriptien(including Proper Shipping Name,Hazard Gan,and ID Number) +h; 4.
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<br /> -No.
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<br /> Quantity 1Nt/Vd 11�u�,
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<br /> J, Additional Description+for MaterialsListodAbove h Rrr!(vj" 3{ondll rk• r dshi<4stedAbevi 4ry W.
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<br /> NL 15 Special Handling Instructions and Additional inFormationl - .;.�w �� "k "•'•'a�, �' k'r'� Q yl "i;'1N' s,w, �r M � ,k,�•tt
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<br /> / .PO# 1011-109 / BRG OUi.de
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<br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of rhi.condgnment are felly and a"ee"n"ro"fsly dieeri6 o6aiini prepsr�hlppirre nems an8 afs eFanFkedpeeked �"�
<br /> marked,and labeled,and ere in all respach in prapor condition Far transport by high.Yey dteordinq to pllikable IKlemaliii In nahena(po ern nW ragulart hi t�r� t
<br /> IF 1 am a large gvonllry generator,f"rtlfy that I have a p ram in ploc■to r.duce Ore'm qmw ry aF wesre pinata a epree.l:haw eNrmin p eeonemitcity '
<br /> practicable and that I hovn.sleeted the praNieoblo method of knafinenl,storage,or diepeiol'eurririlly 16;,I e�fd Fo Ma which leirii(sn'rheppnsenf m d future rhnal ro hura��wYori hslSfFh
<br /> and the environment;OR,if I am'a small quantity generator,I hove made a goad FaiNa eFFett ie'inlnhnCta :weih cenaiviii gn And sslect,Nia bast as(e mahagsilleM nietliof(thof Ci
<br /> available to me and that I can oFFord,
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<br /> rPr�lntsd/Typed Name 920YOVSKY AS AGENT E' R HP
<br /> (� .A 17. Trona urtnr 1 Aaknowl ament of w'. l<Y -• t re r r r�rc r a
<br /> Receipt oFMarorials F`AS .hx9i°"
<br /> A Pr1 yped Na a '.'d1yuu" ..^ ..r• ;;Y I , «
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<br /> 9 18, Tran odor 2 Acknowle emeni of Recoi r of Moeerlals
<br /> TPrinted/Tyl d Namn Signature +ti•'�F�;;k :> :9'r`a!•':�, ` +,,:� Mondt Yex
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<br /> tJ 19, Discrepancy lndkotlon Spoee r �; ,,,r ,,,,t y'1S��3w * �'9; `-;H'i:.
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<br /> 20. FacilityChmer or Operator Certification el reesi t eF hazardous metrrrloia Covered Ibis manlfasr Ol netwd in Item 1 °a•`+"' ^�P'.
<br /> Print■d/Ty*Name Signa s .� t -E; ,r Month Day 'Yxr
<br /> tiro �:.k}��';••.t�.�yp�,^.r,+,':t�,. "Fl,
<br /> DO NOT WRITE BELOW THIS LINE
<br /> Blur .•GEMATM SANDS THIS COPY TO MC WITHIN 30 DAYS,
<br /> GJ CSC 60220 f /991
<br /> •OAOD
<br /> VA 6700-22 To: ,.',P.O. Box;IDO, SafYamen�r cJ1 956i2,
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