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WHITE—ORIGINAL (Return to Generator) YELLOW —TSDF (Retain Copy) PINK —TRANSPORTER COPY GOLDENROD —GENERATOR'S COPY <br />NON -HAZARDOUS <br />1. Generator's US EPA ID No. <br />2. Page 1 <br />3. Document Numbe r <br />of <br />WASTE MANIFEST <br />1 <br />4. Generator's Name and Mailing Address <br />Generator's Phone <br />5. Transporter Company Name 6. US EPA ID Number <br />7. Transporter Phone <br />CLEARWATER ENVIRONMENTAL CAR000007013 <br />510 476-1740 <br />8. Designated Facility Name and Site Address 9. US EPA ID Number <br />10. Facility's Phone <br />ALVISO INDEPENDENT OIL <br />5002 ARCHER STREET <br />G <br />ALVISO, CA 95002 CAL000161743 <br />(510) 476-1740 <br />E <br />N <br />11. Waste Shipping Name and Description <br />12. Containers <br />13. <br />14. <br />E <br />No. I Type <br />Total <br />Ouanti <br />Unit <br />Wt/Vol <br />R <br />a <br />T <br />Non -Hazardous waste, liquid <br />0 <br />001 <br />TT <br />G <br />R <br />b. <br />15. Special Handling Instructions and Additional Information <br />Handling Codes for Wastes Listed Above <br />Wear PPE <br />11a. 11b. <br />Emergency Contact <br />(510) 476-1740 <br />Attn: Kirk Hayward <br />16. GENERATOR'S CERTIFICATION: I certify the materials described above on this manifest are not subject to state or federal regulations for reporting proper disposal of Hazardous Waste. <br />Printed/Typed Name <br />Signature <br />R <br />Month Day Year <br />A <br />N <br />S <br />17. Transporter Acknowledgement of Receipt of Materials <br />0 <br />O <br />Printed/Typed Name <br />Signature <br />TMonth <br />Day Year <br />E <br />R <br />18. Discrepancy Indication Space <br />F <br />A <br />C <br />I <br />L <br />I <br />T <br />Y <br />19. Facility Owner or Operator. CerUticabon of receipt of waste materials covered by this manifest except as noted In Item 18. <br />Printed/Typed Name <br />Signature <br />Month <br />Day Year <br />WHITE—ORIGINAL (Return to Generator) YELLOW —TSDF (Retain Copy) PINK —TRANSPORTER COPY GOLDENROD —GENERATOR'S COPY <br />