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Please pdntorr tyty.e.(Form de ' ned for use on at 12- ch tib. Form Approved.OMU No.2050-0039 <br /> UNIFORM HAZARDOUS 1•Go"Naosto Number 2.Pagetol 3.Emegae Phone Mng Number <br /> WASTE MANIFEST C A,T; 4 U U $ v. Ut `) y i wy Respons(£1!)tl) .i3A-bi3Ru. Q.. Q JJ K- <br /> er Ma�rgAd�r�{ <br /> Generaws$its Address(I dAferenl than meiigaddmz) <br /> 5.G {'a��T:A1.li(1L]IN71kR�?��1lJl`i�T(.1NLLC1 <br /> ' 7 ALARK+I?R <br /> TOGK70N CA Yy�i <br /> Geroratoysphox`. <br /> B.Transporter l CampanY Name ,,Jt U.S.EPAIDNumba <br /> ASPURYEMMONi�-NTAl_^oERVICE3 CAD 0 ii 1, "i 7 O 3 6 <br /> 7.Transpaler2CompanYNama _ U.S.EPA ID Number_ - <br /> 8.Designated Fadely Name and Site Address U.S.EPA ID Number <br /> D DIXON <br /> 7 Y3 <br /> CHEVRON WAY <br /> (11XhN CA C A `P 0 0 0 0 1 2..,C "J,-2 <br /> Fadi' $PhdM: <br /> 93.. 9b.U.8,DOT Desalp6ipndudirg Proper Shipping Name,Herald Class,ID NUMW, 10.Contal, 11,TOW V.VIA 13.Vl"Cod";',:. <br /> HM and Paddna.GrcWIN�yA.... No. Type, Ouanbty wool. - <br /> x71 <br /> NGN-R s(Ll tIA"riu1D0US VYA 'fF,LIQ(Bb(USED oil/MXhCf y)IL) 0 0 T T' T / 3 <br /> W ' <br /> 3. <br /> 4. <br /> 14.Slodal He %N Instructions and AdGgona nforM5on <br /> -?1 tic* 9131 171 PRS)FIL(:N J131:. USED OII.t A kiD(A I ill)DltiOh441 LPA i 460E.:981 :,NOWr APPROPRIATC <br /> t CRBONAL PROW-011VE 1 APP&M <br /> 15, OENERATOR'SRIFFEROR'S CERTIFICATION:I hereby declare that the contents ofthis eDWgmmnt are!Bill ad acouraleiy described above by Ibe paper sNPPbg nam,and are dassifled,packaged, <br /> marked and labeleciplawded,and are N as respects in proper condition Wr transport according to applicable Wlemab"aM national govemmenel regulatorsif export shipment and I am the Pditary <br /> Exporter,I ce*thaUhe tentsolft nsi wnlmklmWUelem ofgaaledted EPAAdaovd*Mntof CWWL <br /> "I NaI'bB wa4teM yetgiiStalamentkentted in4DCFR 282.27(a)(41 Melange quantygereaeta)a(b)(ill aura ural quantlygenemtor)Is We. <br /> Q,sawrel0lfwes Sg Mont–h7 " ear <br /> 10 <br /> 19 <br /> .3 18. lama IW. ❑Mtw to U.S• -.. �TdlpaltromU8. PodaentryteoT: - <br /> ... _ Dateeeving U.S_____.___..— . .. __ . . .. ..._ <br /> 17.rranapata PrluwrAedg�a a l7,orglpt a Mmadela <br /> Trwspata i PdnWWy Nemo - Month OaY Year <br /> ra sponer2 PnntedRyped arse Sigtohas Month Day Yea <br /> 18.Discrepancy <br /> 18a.Diwepalty YtacatmSpaee" �� ❑� ❑Residue ❑Partial Relecton ❑Full Reiectiort <br /> ?60 0 , S p4riftStReference Number. <br /> 18b-ft its FarR/(or Denemsor) U.S.EPA ID Number <br /> FaaAk's flto": Rlontn Day year <br /> ,g�,s ttasaAJlemele acBN a nereWr <br /> S 19.NeaardousWaste Repod Management McRM Codes(i.e.,codes forhaxadousw to beabrent,dispos I.ww recydNsystems) <br /> t. 2 3. <br /> 4. <br /> 20.Oeslgnmed Fadkly0aieraOperator.Cedecationoll"Ptol hesardowneatedalscovered by the manifest exceplasrMed in Item 183 •: <br /> Pdnte ar� Signature r / Day year <br /> r/ ' �, , I -''&, r' r ,. <br /> EPA Form 8700-22(Rev.3-06) Pfevicsolditicalsamobsolete. TRANSPORTER'SCOPY <br />