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JI-IL--2-2008 04:27-P FPOr'1: <br /> $tab of Califaml--Environmental Prol.cilon Aganc, Sas tnstrvcxions on back brDepartment gocramrnro,Ga{'f rnla bsionces�nlrok <br /> Farm Appray.d OMB No.2050-0039;Expires 9.30.991 r <br /> PI.om print or type. Farm detfgned Jnr via on alio 117-plrchl iypswrfter. Manifest Dacument No. 2- Pugs l ln6mation in the shaded area& <br /> I. G.narator&US EPA III No. is not required by Federal law. <br /> JJN1FORM HAZARDOUS <br /> WASTE MANIFEST t' 10 0 12 <br /> A. 5lolrl':lanlla&t DoaumnntNum6ar y�' <br /> 3, Ganaramr's Name and Walling Addr. " ' r' " I/ <br /> Gsnemtor i ID. <br /> . o , <br /> `n d. WnuaWr& Phone <br /> G: State Tran&porier I IP[R.0 ed,� <br /> r\ d. U8 EPA 10 Number <br /> 'ry 5. Tramportar 1 Company Name <br /> tin � r� P. r.i l,) Diran&parter&Phan. M - Fel lir <br /> 0Af2V11MFt ENV1RONMI=N1 E Stola Transporter's ID{R �•l <br /> o? Nam. 4 US EPA 0Number <br /> Tran <br /> 7. sporter 2 Company <br /> _ 1t. Tramtportor's.9hone <br /> d <br /> C3 <br /> State Fae{Ify'►ID . <br /> 9. Da&ignoled loclirry Noma and Sire Address <br /> 14r"US EPd ID Number ` <br /> .Q A;t.VISCI 1NnE:PBNt}FNT OIL' Fac11iky'1 Phone - 't <br /> 1 z 500 ARC14E i STREET ;� f t', r 1 r; l f4 <br /> W CA N`@02 <br /> ,U- ALVISO 12. Cantainar& 13. Total 1d, Unit <br /> tl_ Wt/Yo1 i.WashHumbar'-4 <br /> i Na. T Qeanu _ <br /> 11, U5 DOTposcriptlonpncludf,,gProperShippingName,HaxasdClass,andlONwaharl 3tot." <br /> z a )NON HCRA HAZARDOU,�' If <br /> 1 r EFA/"�hir <br /> WA571:-. t y-::�v, 1. , $lola k, <br /> b- EPA/other <br /> CO <br /> N A7 <br /> b T c. EPA/Qlhar <br /> Q S1nrel, - <br /> R <br /> oc d. EPA/.oy,< <br /> w <br /> V K Handltaq Codas For Waste&Urtad Abow � <br /> N IIInglQ!< art la IIWfr1&lktla uj$. TFt , yG;. oh� = kitg rwi g4�jslZ�� d" <br /> v A �4N4�,x.fr 't' s �,rri r f'.>3°r!3 r�''f ttii� i'•:�`t fi :1F1 p i <br /> lif LLI i r <br /> Z 15, Special handlinq Instructions od Addlliaaal fnforma'"n <br /> VUFAft F't' .�MF.RGENC;Y c'ONIA Y' KIRK HAYWAf�tu i11}-4TfS t7Q0£R�a i <br /> •� / <br /> .hi in nam&and ars clauiFtad,packed, <br /> re that lha conlen!&a€this cone nment ata fully and accurat.l�y described crave 6y Pr�P°r 6 <br /> ld. OETIEIIIATOR'S CEftT1F1CATtON: therebyd.cla cvndiGon for kansp4cl ry highway according to app4icahle international and nali9na government regulation&. <br /> 4 ma"d,and fab.bd,and are 4n oU aspect&Yn Proper p y <br /> l�J �f-ireatmant,storage,ar dispose!c rr�n a'a Ian 1P m ear arl only d tale tetra basltwa�te mawq.mani melhnd that <br /> 11 l am a large gvaMlry gwnaaaroleroW�l��tl rocl cable me h d of rpm In PI 1a reduce the volume an laxiclty of waste ganaraf+d to the degree l rata determined re u to uffic tall <br /> practicable and that f iw p �y <br /> and the anviranmsnt;OIL if I om o&mall quanily generator,1 have mode a gaud faltlt of b minimize my wash ��ontlt Day Yea <br /> ,,ayoble to ms and that I can afford. <br /> OsigWIturis <br /> 0 Print-10TYP46r4r< .r �I <br /> Z \ Mdntk+ �Y- r <br /> LU f 7 Tron& tar I Acknowled ement vF ftecei t of Malartals lura i <br /> LU <br /> A r u !T Nam y`� + --. - <br /> 1 �1J',' fr, i t 1 Nrontr O°y I Ye <br /> r ti.+ f - ni of Racal t 4f Matsriats - <br /> W g 111. Trans arta&a a Signature <br /> . � R Printed/Typed Nama ' ; <br /> L.0Ln <br /> [ <br /> 6 , <br /> 19. Dist:apanry Indication 5paes <br /> z F <br /> A <br /> C <br /> j t - - this manifest exca tar noted in Irvin 19. pl�antfi �y Y <br /> l 20. P.cih weer or 4 rolor Carts{cation aF raeei t of hazardous maroriol5ignatun b <br /> T •Printad>Wy*Noma <br /> Y <br /> 00 NOT wizin BELOW THIS ZINE. <br /> I v uG l._��''���b�\��F !,t'�G � - �-b VL'�•,t�rt!``�A r�`�� ��1� Yvf`3x: e�rlCShrLi� &hire:; <br /> STSC 0022A(1/991 <br /> ' .,8pn;�.. � ...4'� Cif �-� �'�� L.�� G�.. J��' — -� � L` l �•-Y"/J I.v/v <br />