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NON-HAZARDOUS WASTE MANIFEST <br />Ness print or (Form designed for use on elite (12 pitch) ty ter) <br />1111 NON-HAZARDOUS <br />WASTE MANIFEST <br />1. Genes U8 EPA ID No. raloe <br />INDUSTRIAL <br />itanfest <br />MxurneMNo 9 0 7 5 3 2. Page <br />1 • <br />II <br />Gerserataes Name and Meting Address <br />Penske 91 Darcy Parkway <br />2675 Morgantown Road Reading, PA 19607 <br />Generator's Mime 440 -34 9- 2700 Lathrop, CA <br />orter ny Name a. us EPA ID Number Transp 1 Compa A. Stale Transporters ID WAH0000557 1 3 <br />GrayMar Environmental Services r A H 0 0 0 0 5 5 7 1 3 BT . ransporter 1 Phone 7 7 5 - 2 2 5 - 8 12 5 • <br />7. Transpolar 2 Company Name 8. US EPA ID Number State Treneponers ID <br />I _ Tran scorter 2 Phone <br />0 9. Designated Feeley Name and Stte Address la US EPA ID Number <br />GrayMar Environmental Services I NDUSTR I A L <br />E. State Facility's ID <br />I 013203 S. Virginia Street <br />Reno, NV 89511 _ <br />F. Fecirty's Phone <br />775-225-8125 <br />I 11. WASTE DESCRPTION <br />No. <br />12. Contairteni <br />Type <br />13. <br />Total <br />Quan tity <br />14. <br />Unit <br />WtNol. <br />G <br />E <br />N <br />E <br />R <br />A <br />T <br />0 <br />R <br />111 <br />II <br />Non <br /> <br />-hazardous, Non-regulated, Industrial solid waste <br />(Petroleum contaminated absorbent and debris) 001 D M 0 2 5 0 P <br /> <br /> <br />6 <br />II <br />I • <br />G. Adddionel Deiscriptions for Materials Listed Above <br />11.1) GrayMarS (Non-hazardous solids) <br />\ x cc-- <br />H. Handling Codes for Wastes Listed Above <br />111 <br />15. Spedat Handling Instructions and Adabonal I Blinn <br />18. In andalaccurately deeorlbedwaate tic41, are In all respects nGENIERApr TORlionCrToWICKTICt herellacerdifty that th7,noir.ants off thisarahe <br /> !wort ere to federal eut • <br />Date ,.. 4 Printed/Typed Name <br />Kevin Anderson <br />Signature Month Day Year 11‘..1\%_....._ <br />44 kkittki- cSS- <br /> <br />0 91 0 91 2 1 <br />T <br />R <br />A <br />g <br />P 0 <br />R T <br />E <br />R <br />Transporter 'I Acknowledgement of Receipt of Matedats Date <br />Printed/Typed Name <br />Kevin Anderson <br />Sliratura (4.,...... <br />--- <br />A4onth Day Year <br /> , 09 0 912 1 <br />Transporter 2 Adinowledgement of Receipt of Materials Date <br />Printed/Typed Name Signature Month Day Year <br />1 I <br />F <br />A <br />C <br />I <br />L <br />i <br />j <br />Discrepancy Indication Space <br />Facitty Owner or Operator Certification of rece4p4 of the waste materials covered by this manifest, except as noted In fern 19. <br />Date <br />Printed/Typed Name 6...N., Signature Qi,...."\,......................................_ Month Day Year <br />n I 6 I <br />Copyright C 2006. ShipMete, Inc.C, PA Rights Reserved (310) 370-3600 www.shipmate.com