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C�A na I-roti! of rage ! e' .un o U <br /> Please print or type. Form dssrgned for use on a(f2-pr(ch rypewrrrer). 7-185-0 Sacfatnento,Cafl'. <br /> UNIFORM HAZARDOU I- 0-narator s US EPA ID No, me Mf 2. P89*11 information In the shaded areas <br /> WASTE MANIFEST 14,13 617 1 1 1 <br /> Dec of Is not required by Federal law. <br /> 9. Generator's Name end Mailing Address A. $Rate itaniteaf Doertnem Number <br /> TRI VALLEY GROWERS PLNT T. <br /> 26200 NOWEL.L RD N. 1111616 c3.n.rators o <br /> THORNTON CA 95686 <br /> s. Ganerator'a Phone(209) 794-2303 <br /> 6 Transporter 1 Company Name a. US EPA ID Number 60 543 LLQ-U <br /> PE- Nale <br /> e Transporter's 10 <br /> f` �A� �+QRP epodiars Phone <br /> NOAT <br /> 0 7. Transporter 2 Company Name a. US EPA ID Number Transporter's b <br /> porder'e Perone <br /> 2. Designated Facility Name and Site Address 10. US EPA ID Number d3. State FaciftWe ID <br /> SAFETY-KLFEN CORP. 7-185-01 <br /> 5:;5:1 SALIDA BLVD <br /> CAT <br /> CAT 000613968 <br /> i 128, <br /> 'M Q 12. Containers 13. Total` 1a. L <br /> r�0 11 US DOT Description(Including Proper Shipping Name,Hazard Claw.and ID Number) Quantity Unit Waste No. <br /> J <br /> NO. TYpa WI!Vof <br /> L'7v WASTE PETROLEUM NAPHTHA stere 741 <br /> mg a CSM9l1ST1DLE LIQUID t. N1255(DO01 ) (ERG #27) DM p EpA/om.r <br /> N DGO: <br /> C* E b. <br /> N R Stade <br /> A <br /> CIO T FPA/Other <br /> 4 0 <br /> N R <br /> r C. <br /> State <br /> EPA/Other <br /> Q d. <br /> f— <br /> stns <br /> Z <br /> W <br /> U EPA/OIf»r <br /> co J. Additional Descriptions for Materials Llated Above K Handling Codes for Wastes Lialsd Above <br /> a I (A) D039 D01 a a. 14 AND-01 <br /> b. <br /> N <br /> W <br /> ¢ C. d. <br /> J <br /> L <br /> Z <br /> 2 <br /> H 15. Special Handling Instructions and Additional Information <br /> 1 9041 19941749 176555 7-185--01-3077 01 <br /> W ENERGENCY RESP#1 -706-888-4660 <br /> J <br /> SKDQT# A: 501 B. C: D: <br /> J <br /> < le. <br /> U <br /> J GENERATOR'S CERTIFIC.ATiON: i hereby declare that the contents of this conaignment are fully and accurately described above by proper shipping name <br /> and are classified.packed,marked,and labeled.and are in all respects n proper condition for transport by highway according to applicable international and <br /> 11 national government regulations. <br /> N <br /> 11 I am a large quantity generator,f certify that I have a program in place to reduce the volume and tozic$y of waste generated to the degree I have determined <br /> p to be economically practicable and that I have selected the pracricebte method of treatment,storage,or disposal currently available to me which minimizes the <br /> 0 present and future threat to human health and the environment;oR.d I am a small quantity generator,I have made a good faith effort to minimize my waste <br /> U generation and select the beat waste management method that Is available to me and that I can afford. <br /> Z <br /> W Printed/Typed Name Signature Month Day Year <br /> C7 <br /> W fir' '4A <br /> WT 17.. Transporter f Acknowledgement of Receipt of Materials <br /> R <br /> ZA Printed/Typed Name Signatwe Month Day Year <br /> N <br /> W S <br /> O P <br /> LU O 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> < R PrrntedrTypad Name Signature <br /> U E Month Day Yea- <br /> Z 0 <br /> 19- Discrepancy indication Space <br /> F <br /> A <br /> C <br /> I <br /> L <br /> 1 20. Facday Owner or Operator Certification of receipt of hazardous materiels covered by thio manifest except as noted in Flom )9. <br /> T <br /> y Printed;Typed Name Signature Month Day Year <br /> Clark E. Hill � <br /> DHS 8022 A Do Not Write Below This Line <br /> EPA 8700-22 <br /> (Rev,6.89) Previous editiona are obsolete. Blue: GENERATCR HNDS 'N:: ?V <br /> To: P.C. Sox <br />