COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

02/22/02 FRI 11:21 FAX 949 450 1177 B.E.S. I 002 tcxpires 9-30-99' See Instructions on ba Please print or type. Farm designed for use on elite l R 'rl typesvrirer. ' page 6. 's Department of Toxic Substonces Coni UNIFORM HAZARDOUS 1- Generator's US EPA ID No. Sacramento,Sacramento,California WASTE MANIFEST Monist Document No, 2. Page 1 Information in the shaded~arcas r I�AIL O O 0 � �t f � ) is not required 6y Federal law. e 3. Generator's Nome and Moiling address V U ( f / M o C Jpg ARCO PraduCL= Cor�lnsn 7 hof± P-Ct.Box 80$77 w; 4. Generators Phone 1310 1787-4600 L-os Argele; C A 90009 }i. CV 5. Transporter 1 Company Name s h 6. US EPA ID Nu tuber . .A e D98 3 g 7. Transporter 2 Compony Name •�J B. US EPA ID Number T :�Q i m�4-ak.'' Wy+t�t fin, -O•ry Ls a• d.L l.J 9. Designated Facility Name and Site Address _s 1 ;M't�-s•�7+' ,l Q DeMenria Kerdoon 10. US EPA ID Nun bei et' '000 �OOG NorthAlameda Street O CO-M-104, CA 90222 IC-1A IT 10 1 0 1 3 3 5 z ,1- V V 11. US DOT Description(includingPro Proper Shi P Aping Nam®,Hazard Class,and ID Number) 12. Containers 13 Total )4 Unit y _ Y Z o. Gasoline hiudi- e No. T e Quantity Wt/Vol . y 3 3 W203 P.G.IIF, s )got Regulated as a A Waste) C0 N egRCRD M 6. C� f S ao EryL R v A c. o T �•i-W ".c y -4 QF r rl mJ�,, rs a ssJ d. Qdaer `p ��x rt i 0 �{, 1 U 501 r[ yr c zEPA/Ss�r I., r�: ✓! :;T• !• �. "�t-''. ik• ? .+ 'K r,j� „3y} 1 r t �`. Q L c * � a}1K q .gym �t i� "'.T' •`; '�j Y - i�w f'rFf "�t+ s tar rr' s_'Ul<,�yr �s. LU .7.1, .'fir y:. ✓i' s 's r d 3'r. �?"-vF'x .+..:` 77 iz `1 r i `rr n d Q Z O 15• Special Handling I —lions and Additional Informotion Z Gasoline and Wmermlxtwe. Wegr appropriate protective clot Zing ARCO 4932 BFSi# 37638 W (949)753-5826(24 htnlr Frnergenty Phone) 16 first I�ffdinM Way z (949)450-1010(Mt3Inr►to 5mn) Stoddon,CA —Js 16. GENERATOR'S CERTIFICATION: thereby dadore Ihai the conknls of this consignment ore Fully and accurately described above 6y proper shipping name ond'ors claai(ied,packed, marked,and labeled,and are in oll respects in proper condition For transport by highwo r occa ting to applicable international and national government regulal'iossi _i - tf I am a large quant!y generator,I certify that I have a proram in place to reduce the volume and toxicity of waste generated to the degree t have determined b be economically N prodica6le and#hot 1 have selected the�raclica6le method of treatment,storage,or disFosal cu iloble to me which minimizes the present and Future threat to human health and die environment;OR,if I am o small quantify generator,I have made a good faith iffo minimize y work generation and select the bast waste management method that is O ovoila6le to me and that I can afford. }.1 lPrinted/Typed Name Signature ,, `� n Z Mooth�tl�ES[fi5 agent of AP,GO l/1� �J L //µanth Day Year W T / / / tV (� � 17. Trans iter 1 Ackriowiad ement of Recei t of Materials W U, A Pri R / Name w Signature Mon /Do Year • 18. irons oiler 2 Acknowled ament of Recer t of Matenals T Printed/Typed Name W E Signature Q R Month Day Year lJ F 19. Discrepancylndication Space z A C I L I 20. Facility Owner or O erator Certification of recei of hazardous materials co T Printed\/T me s nra`festexce t os noted in Item 19. y t �1 Signa ntft Day Year DO NOT WRIT E,0y1/''IMIS LINE. DISC' 022A(1/99) —22 To: P.O. Box 3000, Sacramento, CA 95812 White: TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS. EPA 87700 e