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07-06-1994 02:31AM FROM PRN Pacific EnDironmental TO <br />Sra'a e1 eolrtwNo—E^�r.nme�N Praecum Aperry <br />Form Ae 41 OM& No. 205a-aa9 tE.p:ve 9,10-Ui See Instructions on back of page 6. <br />Pl.dse prior ,�h,pe. PDrrn de,ipmed rot ase en e6m 112pndr) ryPe"v6•r. ' <br />rA <br />12096383509 P.03 <br />Dapemnwe of Taxi S,barahc« Crmyh <br />DO NOTYWRITE BELOW THIS UNE. <br />Whine! TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS. <br />DISC 9022A 0/921 T�; P.O. floc 3000. Sacramento, CA 95812 <br />EPA 8700-22 <br />1. Ga r', US EPA ID No. Aanilen Document No. 2. Paye 1 Inlamalion m rhe dwded aloof — <br />UNIFORM HAZARDOUS <br />k aD. I cpA ed b, Pectoral Ic-. <br />WASTE MANIFEST <br />Cl Al DI 9181 11 31 71 51 1151 7 0 0 1 10 11 1 of 1 <br />e <br />3. Geroraiar's Nemo and Moiling Adel a�„ .. �11 �%''. . . <br />' <br />NEWARK SIERRA PAPERBOARD CO. 800 W. CHURCH ST_ �.' <br />_ <br />STOCKTON, CA 95203 <br />10 <br />e. GenermDre Phew 209 1 466-5251s a . -' . <br />S. TfanSPoder 1 Canporhy N— 6. US EPA ID Number <br />PETROLEUM RECYCLING CORP. 8 11 5007444, <br />7. T.opo~ 2 Company home 8. US EPA ID hhnnber'�'ti' •r' <br />9. D.h:gnaod FaciOy Name and Sire Address 10. US EPA ID Nvmbcr <br />PETROLEUM RECYCLING CORP.; - <br />13331 NORTH HIGHWAY 33 `I <br />PATTERSON, CA. 95363 1 1C*DjOf3j166j7Z8j <br />12. <br />11. US DOT Vwmpdcn Pod -di -g P -P- ShIpPi 9 Nam, Ho..M Gass, old ID Numbs) No Comansn 13. Taal t4. Une <br />No. T Ovandry 11 Un <br />a' NON RCRA HAZARDOUS WASTE LIQUID <br />'G <br />(OIL, WATER) O 10 11, T I V\111 an ra G <br />E <br />N <br />b. <br />E <br />- <br />�R <br />A <br />T <br />e. <br />O <br />R <br />d. <br />15. Special Hac,Eng msmVarow and Add'iional Information <br />24 HR. EMERGENCY CONTACT: 1-800-874-4444 <br />24 HR. EMERGENCY RESPONSE: CHEM TEL INC. 1-800-255-3924 <br />APPROPRIATE PROTECTIVE CLOTHING & RESPIRATOR <br />16. GENERATOR'S CERTIFICATION! I herby dcelare drat dm con of f he eco ignewom art fulM ood aecureeely deseribod obs by Proper shipping mane end are closslfled, I <br />packed, marked, and labeled, and are in all respects in proper condeian for wompon by highway oceerdinq ro applicable Swim 1, nae and mIemoriowl 10-f. <br />i <br />If 1 em a large gaaaily germromor, I coldly Thor 1 hove a Program in place to educt the . W. and tamdy of woae genermcd re the tlegree 1 have demrmured ho be <br />aeeoamiealy promobk and dor I have selenod he p,.ii bk method of lgamem, %,Drag, or dopasai eunendy available b me which minimius the pr and fu ,c <br />thhean ro hurrah hea arc, aide anvbamrra; OR, 8 1 aro a smog qumairy generaror, 1 have made o geed faith etfed ft miwi my -are generodon and seed the boa <br />weft remoileatewIt method 1101 if ova7abe m me and dhm I mn afford. <br />P`r'eneod/Typ" Name <br />S' n <br />Menrh Oq QYea <br />S' \ lG 1 �O <br />r <br />_In <br />17. TravIsvorrer 1 Aeknov mem o1 Recti Is <br />_ <br />ped Norco Si . <br />pay leo, <br />e2 <br />Aclgo-h m of R ei h ei Mdaioh <br />i <br />Mmfed/Typed Nome <br />S bore <br />mash Day Year <br />19. Discrepancy bc,icai n SDpoca <br />I <br />L <br />% <br />oil' tarot Cerdikaden d r e F hazadou edeh ad b ase ecce m nmed M hem 19 <br />T <br />P' /Typed me 3igMare <br />Day Tea <br />y <br />�' <br />D l <br />.• <br />DO NOTYWRITE BELOW THIS UNE. <br />Whine! TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS. <br />DISC 9022A 0/921 T�; P.O. floc 3000. Sacramento, CA 95812 <br />EPA 8700-22 <br />