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State of California-Environmental Protection Agency Form Approved OMB No.2050-0039(Expires 9-30.99' See Instructions on bC I page 6. Deportment of Toxic S46ance Please print or type. Form Jesigned for use on elite(12 typewriter. Sacramento,Coliforni, 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas UNIFORM HAZARDOUS is not required by Federal law, WASTE MANIFEST C Al .Tj 010101 1 C� 9 4 9 l'I S1 11 if'J, 3. Generator's Name and Mailing Address :A: Stote.Manifest Document Number 2201451% }r� I 1LAKD P&P INC (#02,0—TRACY) 2 2 014 5 1% h 400 WEST V fLPICO ROAIa., TRACY, CA 95376 B. State Generator's ID W') A. Generator's Phony (V 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID[Reserved.]. h 0D d+RITAfJE TRANISPORT LLC / SIGNAL H' P D. Transporter's Ph na__ $ i H D (t 5r E; 4 4 1 1 4 1.)6 )535-02 G9 7. Transporter 2 Company Name 8. US EPA ID Number E..State.Transporter's ID-[Reserved) F. Transporters.Phone V00 LOU 9. Designated Facility Name and Site Address 10. US EPA ID Number G: State Facility's-11) v" �Q H+R!"GE ENV I ROUNENTAL SERVICES, LL 512.2 EAST STOREY ROAD H. Facility's Phone ®0 COOLIDGE, AZ 85222 A Z DI it ;_; 1 7 Cl ` 4 0 2 520)723-4167 �Q 12. Containers 13. Total 14. Unit C�jU 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No. Type Quantity Wt/Vol I.,Waste Number 1 = NON TICRA HAZARDOUS WASTE LIQUID), H O.S. , 9, G state 241 3 GN A;;0621 Pa i I i, (USED OIL) ERG# 171 'EPA/Othe6l�� 0 fi tT E y,' o NN014 RCRA HAZARDOUS WASTE SOLID (OIL`' ABSORBENTS) State 921 CD act E R D I EPA/Otho r- L` C14 = v' A vm..�G,..-_.- ..• r-,r ,,,•r,,sr of 74, - .....-. - r,n state "�,"}+ O T TE c.l l ii l\1 L^ H L'a' p r:1.J Li ii L� r T�.' -.T�. L�p T ti L Y.i_ 'Y F L ` L i L a0 01 ... ~'Y yr.r..f.r. . 1 .. r u.. .. f1 L+ RIC-� , :l stn , 1J.,CSL 1 "I W Drs 1 1•,+ 1- 'EPA/Othel�s;E c wrw d,n� _ nnmr ;•:teM �, E State W , 5R, v EPA/Other w N J.Additional Descriptions for Materials Listed Above K..Handling Codes forWastes Listed Above Z 0 A. 64495-3 b. L0 B. f'i44 _s-2 LU r:3 -F - C. d. Z p15. Special Handling Instructions and Additional Information p O 24 HOUR EMERGENCY PHONE #: a Z w 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, Q marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. U J If I am a large quanti generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economical J g CL practicable and that I ave selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to'hurnan heal to and the environment;OR,if I am a small quantity generator,I have made a god faith effort to minimize my waste generation and select the best waste management method that available to me and that I can afford. O } Pr' /Typed Na Signa Mont Day Y Z -1 6h LU T 17. Trans rter 1 Acknowledgement of Receipt of Materials R LU p Prints /Typed Name Si r Month Day Y W P 3 o U. 0 1 Tr ns orter 2 Acknowled ement of Receipt of Materials 0 R Fri d/Typed Ndma rr rr ignature /Jf1 t� Monti ©Dcy� Lu R l/1 Q: ...•� 0 `J U Yv Gl.✓`'t /�,/ /Vit (_T/ I a U 19. Discrepancy Indication Space ' Z F A C I L l 20. Facility Owner or Operator Certification of receipt of hazardous materi covered by this mcm4aQ except as noted in Item 19. T ted/Ty�ed Na e A Si nature Month Day Y z:- DO NOT WRITE BELOW. HIS LINE.