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06-/30/2010 10:52 12093341873 FLAGCITY CHEVRON PAGE 02/04
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<br />EPA Form A70n-22 (Rev. 3-05) r-'reftLM ndIllom, am obsolete,
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<br />'OUNIFORM HAZARDOUS
<br />f. 6weretor ID Number
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<br />WASTE MANIFEST
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<br />G, Twqxro" I COITIDnAy NAMO LI.S, FPA ID Number
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<br />R. DoWgr(Aled Facility Namp and Sita AddrrAqU.S, EPA 10 Number
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<br />fab. U,3, OOT DP-9dp0an ()rKiWW Proper Shoft Maw, H=rd Cl,an, ID NUMIM,
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<br />No.
<br />Type
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<br />14. 6 ecid Handling InssITICUMS And Additional InfatMAthn
<br />IS. 0ENEMTW5WFER0R'SQPRTIFICATlM: I IlMbY "re Ihitt he conte* of thin CqnalgMent are fulyaM m=fF40 dosodW Wove by the proper ehipping name, arx! Ara clavrow, podeped,
<br />mBdced gM and Fire In all rospftcls In proper candftrl for tmnq)mt Aroording to applicable Irgernallonal and national gNmrnBrod regulmilone. If export shipment and I am thia Primary
<br />Exprrrlet I m"Ify thoilho w0nM oft* rons1nowntcoribm totilo ". or the aw-wl EPA AcKnDrAmtrnwa of cm1w.
<br />I nwfh✓ that Oxmmin mInITOMionstalannent Idnalfe.d in 40 CFR 762.27(a) (If I Am n hrgaqwndlygerterefor) or (b) tYl RM a qTrrA qWflIY 9811SWOPA iTUS.
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<br />Gfhv.r,alorr,-K2fnmr`q PrIntedrryped Name
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<br />14, I-to7oWun, WaRle Rapon Management Method Codas (f.e., a(Ana for lhazarfto waste Irsalmrit, dlspo,,#Al, And re -cycling systerne)
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<br />i, Notice, New federal form. State of
<br />California requires generator to photocopy
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<br />In 110m 18r 2nd all to PTWwithin 30 days:PD,
<br />20. Dpaignatrid Factilly Owner or CrwaW. Cw"Wlem of wm int of imnrtous m,**A owerv-d by the FmNftW exfAPI OR noted
<br />Box 400, Samnmto, CA 95812--0 400
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<br />EPA Form A70n-22 (Rev. 3-05) r-'reftLM ndIllom, am obsolete,
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