Laserfiche WebLink
Please print or gpe.(Form designed(of use on elite(12•pilch)typowrifer.) _ Form Approved.Will No.20500039 <br /> UNIFORMI]MAROOUS I.GenermixiD Number 1.Pzgo tot 3,Emergency Response Phone 4.taanlleel Trae"Number <br /> WASTEMANIFEST CALOOU269375 1 (800)•124-9300 011827242 JJK <br /> S.GeneratorsNanw and haTngAdMess Genermo(s SdaAddless(ddlberent Hun mar'ngaddress) <br /> PICK N PULL H60 <br /> 2927 CLARK DR 3927 CLARK OR <br /> STOCKTON CA 95205 STOCKTON CA 95205 <br /> Genaratofs PMta: <br /> 6.T*ne rh1Company Name U.S.EI'AIDNombmr ! <br /> YIRONMENTALSERVIC:S D029277036 <br /> 7.Transpoder 2 Company Name U.S.EPA ID KwrAer <br /> 8.Despnaled poorly Name and Slamdmm U.S.EPAID Number <br /> DK DIXON <br /> 7300CIIEVRON WAY <br /> DIXON CA 95620 <br /> Fab' (a Plana: (7071(393-6008 :A T O 9 0012602 <br /> ga, 9b.U.S.OOT Desc46m(iechefngProper ShWag Name.Hazard Class,IO Number, 10.CaNahnna O.Tomi 12.Umt i3.'.'yas!e Codes <br /> am PazFngGroup(dany)1 <br /> No. Typo Ovantgy %""w <br /> o NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OIL) 00i IrT 0 221 <br /> {I! <br /> W <br /> 3. <br /> 1 <br /> a. <br /> 14.Specla lfarasrg InslmUMsamAndtomtl Infwmalon <br /> NAERON 9Bi:171*PROFILE k 9131:DHOH94 EMERGENCY CONTACT;CHCMTREC 1.800424-9300 <br /> ADDITIONAL EPA CODES:9Bi:,NONE*APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT <br /> I6 GENERATOR'&OFFEROR'SCERTIFICATION:Ihembydeabrelhatihown'znls oldu's tansagnmenlare My and aama"desmbedabo•.re bJda proper A 9 ig name,ani are c!assls4q PaOamd. <br /> marked and labettUacmded,am am in agmspecis in proper comtbn for bampodacmdrg loapp'mme Inles"fenaland tatcnai gazrnmemal tegulatcm.Warped sh'prtent owl I awts Pern e y <br /> bPwtw.I ceflRy mum cwOenls a]ws crosignmanlmMmm to 84 buns of Oa mached EPAAckmniedgmenta coment t <br /> I cw6y Oat No vasa oWnfidensalemenl IdenOped in 40CFR 26227(a)(if I amabsgaquanerygenerabU w(6)(111 awns a sma9quanbgganeasw)is true. <br /> Genemtafsl06e er;Pdn'AdffVName Si9naMe Month Day Year <br /> r1v <br /> —s 16.IMematanal Smpmems <br /> 1:11MM11DUS. ❑E.pwlkom U.S. PalWenlrylink <br /> Tfampoder signalum(for aspats"/I Dale leaug U.S.: <br /> 17.TmaspoddAtkno anlatReceylo7Aahnah <br /> 7ranspwl yped Name Sgnalwa <br /> O h!om/hx� Day re <br /> ria <br /> Tr PdnbdRyped Nam two Uonth Day Year j <br /> } 18.0¢cmpancy <br /> 18a.NumpamyMdcatbn Spam ❑Owns El Type ❑Reidue ❑Ponbl ReVP;n ❑Fu7Rejeckn <br /> hiawfesl Roferemo Number, <br /> I8b.Akernate Fac4y(or Generatw) U.S.EPA ID Number <br /> t'S <br /> saw FWAy's Piave: <br /> I c. .valve olNlanab FacV•Ty(ar GemsaaQ Mw% Day Year <br /> Q <br /> z <br /> Nig,Haea sVY slo FeqpdjAanjU,mert Me"Codes;U.a..cedes fm hazardouswasb Oeament,disposal,and rec}cvn9 systems) <br /> p I. 2. a 4. <br /> 20,0efgnwed Faoty Aneter0peraW..Ce k6onolne4plolhzx us makdahmeercdOyOre manAesl eanepl assKre IBa <br /> PsinledlTypadN ^ s , , ffgnalure IN,— Day_ Ycar <br /> V3 <br /> EPAFeam8700.22(Rov.305) Piwiioos eddians are obsolete. DESSIGNA1"ED FACILITY TO DESTINATION STATE (IF REQUIREO) <br />