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13tde of CaltlArriia--�Mal�h and wollf <br /> 4WS W. <br /> +e txhM t1l type Forrfi deelgntld fbroa fiq$IUte.Tf1•pRO UAB: + <br /> UNIFRM HAZARDOUS r tor,U3 .A, <br /> .41'-WAS7E MANIFEST1-01" <br /> w Jit <br /> Jit <br /> i <br /> To <br /> CA 906 <br /> 4. Generator ll 74"IG+��fi,W <br /> 6. Transporter t Company Name " a ;''US EPA Irl.N"W, t'SAFETY-KLwi�m CORP. <br /> Ir ewoal - <br /> < `: <br /> N <br /> 7. Transporter 2 Company Name d US;SPA ID Nntiaber x <br /> _ 9, Designated Facility Name and Slte Address10. US EPA ID Number 4LI.SWR P _ &E! ha <br /> f Y—�BgEN CORP ._ 7-385 .f. { : x ' <br /> < SAL I DA BLVDCAT <br /> 14 <br /> SALIDAi CA <br /> ,,;_ <br /> 12`Contaliters t9.Total - 14: r� <br /> O 11. US DOT Description(Including Proper Shipping Name,Hazard Class,and 10 Number) Quardtty Unit WRata No <br /> u. No. Type lift/vol <br /> r` e. WASTE PETROLEUM NAPHTHA Y R ■ <br /> �Z Cls !HUS "IDl E X4UiD tJri I2 S� 1 > EERG -� �r €? F <br /> } E <br /> Jij Ft <br /> T. .. GROW#RS -,c., ��r ��,y::..s•. - �y� I :�;�� t 4'� �` �� _: .�� rrti ',� ^� ` <br /> .4 Q r : <br /> a R C. PLAt1t <br /> rye � dry/rye`) <br /> APR 2 iJ I1 <br /> d <br /> WQ """""'"""� A - - ro.. ;:f ...h.i �.. sir •y,A ew,� <br /> *1¢W?$q ��S; k <br /> Lu <br /> Cl) J. AddttiopAj Descriptions for Material*Lismad Above iK Fiat�np � !or YYattae Listed AtlotNi: y <br /> Z 0 ICA) 0039 D01a <br /> Lr r � r r R �j�w' tr4 m!X # P <br /> wt yic as t, rr R� Fa 'S t) 3 „ <br /> . <br /> yr �,�s•.. 9�' �g <br /> J , k, a r a* +. ♦ -trs „. yly3' �, <br /> srm a 1 vt x.i:.. �3 +k`Y• •r�, m <br /> 16. Special Handling Instructions and Additional Information <br /> 9113 25239674 278812 7-1e5-01"'30711 . V+. <br /> Z EMERGENCY RESP#70FS-88$--4664 24##t <br /> 1e - <br /> OF-NERATOR'S CERTIFICATION: i hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name <br /> and are classified,pecked•marrked,and labeled,and are in an respects In proper eondltlon for transport by highway according to applicable k,tarnatlwal and <br /> tL national government regulations.... <br /> in N I am a large quantity generator,I certify that t have a program In place to reduce the volume and foxiclty of waste generated to the degree I have determined <br /> to be economically practicable and that I have selected the practicable method of treatment•storage,or disposal currently available to me which minimizes the <br /> present and future ttweat to human health and the environment;oil,.If I am a small ouantlty generator,I have made a good faith effort to minimize my baste <br /> U M <br /> gen lion and select the best waste management method at Is available to me and that I can afford. <br /> tw7 Printed/Typed Nath¢.. Slgnafure + P11 <br /> a <br /> W JF <br /> WT 17. Trensoorter 1 Acknowledgement of Receipt Of Materials t <br /> R <br /> ZA P+intedrTyAad Name Signature ar <br /> C LL Noel Tbornton <br /> GI c <br /> w O 18. TrP-nsDorter 2 Acknowledgement of Receipt of Materials <br /> Cn P wimedr-yped Name Signature Monff: Day Year i <br /> U E <br /> Z <br /> f 19, Discreoancy indication Space <br /> 1= <br /> A <br /> C <br /> , F <br /> L <br /> 20. Fscii ty Owner or Overstor Certification of receipt of hazardous materials covered by this manifest except as noted in Re 19. <br /> da <br /> y Printed rTypad Name Signature I <br /> Clark E. H111 ' <br /> DHS 8022 A Do Not Write Below This Litre <br /> EPA 8700-22 <br /> (Rev.8.89)Previous editions are obsolete. <br /> Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS <br />