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NON-HAZARDOUS WASTE MANIFEST <br />Please prird or (Form dealgned for use on elite 12pitch) ter <br />II <br />NON-HAZARDOUS <br />WASTE MANIFEST <br />1. Generator's US EPA ID No. <br />INDUS TR IA L <br />Ma nifest <br />MicumeMNo. 9 0 7 5 3 2. Page <br />1 ii 3. Generator's Name and Mailing Address . <br />Penske 91 Darcy Parkway <br />III <br />2675 Morgantown Road Reading, PA 19607 <br />Generaloes Phone 4 4 0 - 3 4 9 - 2 7 0 0 Lathrop, CA <br />Trate:potter i Cornpany Name e. US EPA ID Number A. Stete TransPodoes ID WAH000055713 GrayMar Environmental Services A H 0 0 0 0 5 5 7 1 3 r B. Transporter 1 P hone 7 7 5 - 2 2 5 - 8 12 5 <br />7. Transpolar 2 Company Name 8 US EPA ID Number <br />, <br />• <br />C. State Transporters ID <br />I -, D. Transporter 2 Phone <br />0 9. Designated Fecity Name and Site Address 10. US EPA ID Number <br />GrayMar Environmental Services I NDUSTR IAL <br />E. State Facility's ID <br />413203 S. Virginia Street <br />Reno, NV 89511 . <br />I <br />. F. Fealty's Phone <br />775-225-8125 <br />11. WASTE DESCRIPTION I <br />No. <br />12. Containers <br />Type <br />13. <br />QuantityQuantity <br />Total <br />14. <br />Unit <br />MAIO. <br />a. <br />II <br />Non-hazardous, Non-regulated, Industrial solid waste <br />(Petroleum contaminated absorbent and debris) 001 D M 0 2 5 0 P <br />G b. <br />E <br />N <br />E <br />R c. <br />A <br />I <br />0 <br />R cl. <br />II <br />G. Adaional Descriptions for Materials Listed Above <br />II <br />11.1) GrayMarS (Non-hazardous solids) <br />II <br />H. Handling Codes for Wallies Listed Above <br />111 15, Special Handling Instructions and Additional information <br />I <br />18.17.14ERAIN TOR'SonC7171CAT/ONT,;:! hen% jecertfly thzatecith:norsents of thisarshe Ipmseruitbiasetre fircx)Ir anclalsocurately ctes:strtedw turna are In ell respects 1 manifest <br />Date - <br />Printed/Typed Name <br />Kevin Andereon <br />Signalise I........, <br /> 114 lUseit.i- <br />t <br />4F0- <br />Month Day Year <br />0 91 0 91 2 1 <br />T 17. Tranaporter1 Acknowledgement of Receipt of Materials Data <br />R <br />A Printed/Typed Name <br />g Kevin Anderson <br />Signature Month Day Year <br />0 9 1 0 912 1 <br />P 0 18. Transporter 2 Acknowledgement of Receipt of Maierials Date <br />R T Printed/Typed Name <br />E <br />R <br />Signature Month Day Year <br />1 1 <br />19. <br />F <br />Dim, span-y indication Space <br />A <br />C <br />I in item 19. 20. Facility Owner or Operator, CertifIcadon of receipt of the waste materials covered by Hs manifest, except as noted <br />L 1 I Data <br />T Printed/Typed Name 6...4,1/4.. <br />Y 1.41f- J 11N) <br />Signature QL.....\............................_ Month Day Year <br />ni 6 Ck I -\ <br />Copyright 0 2006, ShipMete, Inc.0, All Rights Reserved (310) 3703600 vonv.shipmate.com