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DiBl'f'l1AZAR000S i 3eneraar ID Numoer 2 Page 1 of J.Emergency Remorse Phone 4 Waste Tracking Nunitler <br /> WASTE MANIFEST C A L 0 0 0 3 8 7 9 2 0 1 800 42.4-9330- CHWTf?a�; Id IJ 7 1 .6 Sf - <br /> i'791�l tRVICES INC "Al ofAST RVcS INC <br /> 1020 E.ALPINE AVE A200 1020 E ALPINE AVE <br /> STOCKTON CA 95204 ST^."KTON CA 95204 <br /> eneraAra Phone; 816 364-3000 <br /> n Tra Lwle 1 Compary Name US.EPA!D Numbe, <br /> FREMOUW ENVIRONMENTAL SERVICES INC C A R 0 0 0 1 7 1 0 1 7 <br /> er+parry Name U S EPA!C Number <br /> I <br /> t6laff—m- 'MIIt1 $1e SILL, INC. US.EPA 10 Number <br /> 3675 POTRERO HILLS LANE <br /> SUISUN CA 94585 <br /> acti,'e P woe 707 42.2-4627 <br /> 9 'Was.e SnPP nG Name ane Gwnouon 10 containers , Total 12.UN <br /> No. --r--7ypa_� :7varwty WiNd. <br /> Cr ROCK)NK)'OIA., OT)�- WASTE SOLID(OIL IMPACTED <br /> 001 C �Y. y <br /> a �.. <br /> ;' <br /> ter. <br /> A , <br /> s 11t �" 0"' on <br /> t -° aoz'goto ock(enatytical provided to disposal facility) <br /> R <br /> i <br /> L 14.GENERATOR'SIOFFEROR'S CERMCATtON:I hereby deciam ths:the potents of this consignment are h y and accurstsy described above by the props,snipping we,end am daaeffied Puke* <br /> marked aro 4o,*0 a 4mw and ant'n ea mmpects in proper ccnd lon for Uarttpprl accar 'v b opkable 1.tematbnai end national govemmar al%aWbons. <br /> GmerataraOPeorePnusd�ypecNama�✓T2IOt/Z+ITIcNl4,J_...___ --Sigma----�vr• c�n+a i s��— µ y Yea, <br /> j /477ZlC*— RA,00ZD <br /> J ,anar"rte $y�r�ature tore.c.;rs cn� lmoort to U 5 _-- J E,Pon 1.U S Poneceav' <br /> ryfeM <br /> Dy VS_ <br /> a; fi Transporter Acicr"edgmard of Recalpt of Matertais <br /> fwsL rAar PdniftTyDei 48'a Spnalum MortDay Year <br /> O - <br /> a 1_ _. / /-7 <br /> cn._.___.�lsx-_�ar34es _—_.�—_--_--- __._____.— <br /> a T ranscorter 2 PdntWvl ed Ne^me Slgnawre ---_ Norm Day Year <br /> 11.Dxrepancr <br /> ( t'a Discreom,ndkabon Space Quankry Fettle!Refection ❑Full Refection <br /> I Manifest FW*rwlce Number. <br /> '7t A,iemale Fac"(or Gweratw) U.S.EPA nJ Number _ <br /> l: <br /> Lo - .gna!uT d ArorrWe Fact9ry(cc Generator) Mor" Day Year <br /> i <br /> sn <br /> w <br /> 0 <br /> IS De4ralsd Fadaty oWngr or OperalDr,Carttikallor el receip!of materias covered by ate merriest except as noted In Item 17a <br /> Pnnte-"TLr d!lama Slgnaturs Day Y <br /> iB9-ElLG05 TTerr(Reu.9/09) VIL <br /> , I}ESiUNATED FACILITY TO GENERATOR: <br />