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Store of Califomia—Endromn;Lld Protection Agenq " <br /> Form Approwd OMB No.2030-W39(Expires 9-30-96) .S/G Inshuc}Ions an back br*gs 6. Department of Toxic Substances Central <br /> Pieces prim or type. farm designed lar use oe IH*(12gecM)ypwdbr• - Smomemo,CaBfomia <br /> 1. Gecuralers US% <br /> PA ID No. - Manifest Document No. 2. Page 1 Information in the chaded areas <br /> UNIFORM HAZARDOUS ; _ is net required by Federal law. <br /> WASTE MANIFEST <br /> 3. Generator's Name and Mailing Address <br /> O <br /> h HMR RANCH <br /> N P.O. BOX 908 MILLBRAE, CA 94030 <br /> `' m 4. G—razor,Plane (415) 697-1655 <br /> $ S. Transporter 1 Company Nanta 6. US EPA ID Number <br /> ALLIED PETROLEUM ICIAILIOICIOIIII12131114 <br /> re J <br /> J 7. Transporter 2 Company Noma B. US EPA ID Number <br /> U <br /> U <br /> �Trrn spoilers:Ah <br /> Q 9. Dad rated Facilitynta Naand Sin Address 10. US EPA ID Number $fan f«iJft 10 d. <br /> ce AMkRICLEAN, INC. N'V;C! 9 $` <br /> (� 2570 ALMOND DR. <br /> . a SILVER SPRINGS, NV 89429 INIVID191812131518141813 -577=9DOii <br /> .. 0 <br /> Z 11. US DOT Description(including Proper Shipping Name,Hazard Liao,and ID Number) 12. Comainen 13. Total la. Un�r .-.. <br /> No. T Wa Wt/Vol 1. WazteNembar-:- <br /> NON RCRA HAZARDOUS WASTE LIQUID s <br /> see G - ' T T G 'EPA,GNe; <br /> r E <br /> 03 N b. Stcta'.� <br /> E <br /> N R - ' ..EPA/ r <br /> res, A >si. <br /> aa T C. <br /> 3rcra <br /> O <br /> a, R <br /> EPA./ <br /> W <br /> see � � d. <br /> U <br /> W EPA(, <br /> Z <br /> a <br /> w <br /> c <br /> J <br /> r ' <br /> Q I3. �F H dtin I �t'1�,qgd alInfornation PICK—UP AT: GOODYEAR TIRE Q RUBBER CO. <br /> a tYtl��i°�RaIPLilvc � ? 1131 HOLLY DR. <br /> Z <br /> 'FACILITY 702-577-8001 <br /> hour = GENERATOR. 415-697-1035 TRACY, CA <br /> J 16. GENERATOR'S CERTIFICATION: I herby declare then the contents of this condgr mset an fully and accurately described abase by proper shipping name and ors classified, <br /> J <br /> Upocked,marked,and labeled,and me In a8 es <br /> rpscte In pro;.,condilbn for fransport according by highway eord'uq applicable international and rational gowmmann regulations. <br /> Use s <br /> If I am a large quantity generator, I certify that 1 haw o program in piece to reduce the"fume and toxicity of warn generated to the degree I haw determined to 6e <br /> yeconomically practicable and that I haw selected the practicable melhod of treatment,storage,or disposal currently owilable to me which minimizes the present and future <br /> N threat to human heahh and the emfremnenh OR, R I am a small q.*generator,1 haw made a good faith effort to minimize my waste generation and select the best <br /> K <br /> r warn ma emeM method that is a"il ble to me and that I can afford. <br /> O P� LTYped No Si e- <br /> yy Month Year <br /> U <br /> Z <br /> 1 17. Tramp a 1 A knewleclem I Receipt of Materials / <br /> e. A Printed/Typ94%nit Signotun ///; Mh Day Year <br /> f P m , e ont' <br /> ,y 0 18. Trar 2 Ackrawled amem of ei t of Materiels <br /> ,y T PH t d/Typed Name Signature .Month Day Year <br /> Q E <br /> s. n <br /> U) 19. Discrepancy Indication Space <br /> U F <br /> A <br /> Z C <br /> Issr — I <br /> I <br /> • <br /> , 20­ <br /> F«il' Owner er Operator Certification of n.e t of hazardous materials covered b this manifest exca t as rioted In Bem 19. <br /> T Printed/Typed Noma Signalun Nomh Day Year <br /> Y Ze c) //' f, �,� n / i9 7 <br /> DO NOT WRITE BELOW THIS UNE. <br /> DTSC 8W2A (1/93) Green: TRANSPORTER RETAINS <br /> EPA 8700-22 <br />