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f <br /> c <br /> Pleasepdntor .(Form designed to(usson eife(1P-pitch)typewriter.) FannAppmved OMB No.2050-0039 <br /> UNIFORM HAZARDOUS l-uenemwrlDNumber 2.Pagetal 3.Emwrgmxy Response Phare /.Maslfesl TtaoNing Number I <br /> WASTE MANIFEST 00 2 37 1 SDP azo-9300 : 011827253 JJK I <br /> d.0enwalbA Nano and Mailsg Address GammlpeA Site Aftess(ifcIrt limn noting address) - . . .. <br /> PICK PULL#SO <br /> 3927 CLARK DR 3927 CLARK DR <br /> STOCKTON CA 96205 STOCKTON CA 96206 i <br /> Generaloes Phow 9i&099- 000 <br /> b.Transporter 1 Campeny Name - U.S.EPAIDRWAW - <br /> B E D029 7036 I <br /> 7.Trentpalee2Comparry Name U.S.FPAIDNm6w <br /> 8.Designated Facility Name and SdeAddfess U.S.fPA10 Nun8x •. <br /> DK DIXON <br /> 7300 CHEVRON WAY . <br /> Fa if Pfme: f70-71941.6008 CA 95920 AT080012602 { <br /> 9a, 9b.U.S.DOT Des6peon 9nok&g Proper SNppNg Name,Hazard Claw,ID Number, 10.0O202l8i Ml )),Tay IY IBA I I <br /> Wand PeJdrgmu <br /> Gp(lany)) No. T ..OXY WEN61. 13.Wram Codec <br /> YPa <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OIL) 0 0 i T �y`� 0 221 <br /> bL/ i-- <br /> W 2• <br /> 3. I <br /> 7 <br /> I <br /> 4. i <br /> 1 <br /> I <br /> 14.Special Fiaroft lnsbuctima aAdditbmllnformavart I <br /> NAERO# 9B1:171*PROFILE#961:DK10O194 EMERGENCY CONTACT:CHEMTREC i•900.424-9300 <br /> ADDITIONAL EPA CODES:9Bi:,NONE*APPROPRIA j? PROTECTIVE EQUIPMENT i <br /> 15. GENERATOR'SIOFfEROR'S CERTIFICATION:IMrebydedarelhat lha canterrls ofN l are"and aauratesy described above by(M proper shipping name,and are dasWed,packaged, i <br /> marked and labeled/placarded,aW wain all respects in prepercon ift fabanspod aaumhg to appiable Wemalbnalard nationalgovernmental regulatians.if export shipment and Ian the Primary <br /> Expata,I cedeythat the mntemael M mmlgarenloonwrm to ere lennsoleta aftodwd EPAAcknowledgmenlof Conley. <br /> I certify that the waste minimization statement IdenOedin40 CFR 26227(a)(di am a targe quanttygenerator)or(b)(NI ama smal quanaty generator)Is we. <br /> GenerawYslDllemYS Pnyed/iyped Name Synanxe Mayh Day Year <br /> c v LIZb i <br /> -r IB.MIema0onal Shdpmeys <br /> ❑ I <br /> ti Nrpad U.S. ❑ExpM fran .S. Pad of enlry/e <br /> Transport"slgnalaa(fa exports Only): Date leaNrg U.S.: <br /> W 17.Tramporler AVoMradgrnental Receipt o!)"Is <br /> Tr P'teNTypeme d NaSgnNp MmN Day Year I <br /> a � _ <br /> Ira r P' dName SlgnNn9, _ bloom ay ear <br /> L17 V <br /> f <br /> 4. 18.Disaepanry I <br /> 183.DlsaepancyMkallon Spam ❑ psand I. <br /> ty ❑Type ❑Raswue ❑PaNei RaNaan ❑Full Relectian <br /> Horniest par erenm Number. ( r <br /> ibb.Allemate Facility(aGeremwr) U.S.EPA ID Nanlrer I <br /> U <br /> LL FacWs Phalen <br /> w I&-Signalae ofAllemals FadEry for Genemta) Day TW <br /> a i <br /> z <br /> y19.Hazardous Waste Report Management Method Codes pe.,codes for hazmdoas waste wetmant,disposal,and recycling systems) r <br /> 2. 3. 4. <br /> 20.Designated Facfity Gmaa Opemtar:Cer6BmUmof reo*of hazardous mataUs covered Uy Uw nangesl exmpl m ndedln Ilam 18a <br /> Pdr9ecIgyPed amu S!gnalure 4 Moah Day Year <br /> �0 <br /> 04 1 <br /> FPA Form 8700-22(Rev-3-05) Previous editions are obsolete. DESIGNATED FACILITY tO DESTINATION STATE (IF REQUIRED) <br />