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Stab of(pearro—Hear and welfare Agancy „r�+ '`:Deprslnynt of Health Service, <br /> Fair,Fpvlw,d0fA No.2050--0039(Bohn 9-3091) See Instructions on kofpage 6. To,dc SubslorrCe:car,o-a Rapmm <br /> Recce p"o type. fam devpned for rse an elfle(,h fype fft.0 1. _ Soaamenb.Cditrk <br /> UNIFORM HAZARDOUS1.GeroaorsLis EPA IDNo, MlarfleftDocurwrtNo. 2Wpe1 Womatbnin the OWXWmom <br /> WASTE MANIFEST CI At Dl 91 81 11 41 51 91 91 41 OI 01 DI Of 1 aft 4 not reared by Feded w. <br /> Marne od Maiisp Addren :A,31ah Mahretl D9cuR+etR NiRnpef ,. .elf <br /> tchinson Topeka b Santa Fe Railway <br /> 40 East Cargine Dr. ,&State <br /> aa.r&tn.vlaa;Fllno, TCA 924083598 <br /> S.Tronpoteri 6.lA EPA ID tamper C.8066 Tfaregodert ID <br /> Dillard Trucking. Inc. A 1) p 1 6 9 4 V 9 <D. 1im,WQaersP1= <br /> 7.Trareporler 2 CompoYy flora 8.US EPA ID Nur r GG /L :E Scale TrorepOdeff W OI(YQ�+ 7 <br /> Ila <br /> 112 1G/ 1 / 1 1 / W Iv rj f(�fArdro V VVVtl <br /> 9.Deaprtoled FociN None and See Adp�ea 10.lb EPA ID Nuriber 6, to - <br /> e r Cum Recycling AVO— <br /> #}= 61 t!}jtt;if 1i 31 '1=91i <br /> 835 East 29th Street <br /> mignal Hill. CA 90806 <br /> td} 11.lb DOT Deroption(kncWN Proper Shgpky None,Immd CI®,and ID 1,I.N. 2 Con vwa 18 Tod 4 UN <br /> No. T Quardth, w1Nd 1 W¢te Number <br /> J a Sim,,. <br /> I U G <br /> N Q E 'Non RCRA Hazardous Waste Soild 010 1 D1M 010121510 P e <br /> 002 N <br /> 1 <br /> No E <br /> C oI At <br /> RECYCLING CERTIFICATE Vie <br /> Ra, <br /> TO `Petroleum Recycling Corporation certifies that the <br /> R above mentioned wasters),more specifically irdentifled EPA/ORer <br /> as 3 reference tot 1 MAY X1411993 <br /> s WaSAWM <br /> °recycled in accordance with the provision:cf40CRF761.6 €NVI N Star, <br /> v and 26.4 pursuant to 40CFR 261.3(c) (2)ha;ardour waste <br /> aeratedt <br /> Of 4j) xHowk,ocod,fTawanetunedApoV, <br /> n b <br /> Z <br /> Absorba� >E �pINtiCt>RPORA 4 <br /> w <br /> U 1 ars Ir• .. <br /> w <br /> H <br /> Z <br /> Wear Proper protective equipment. Job 8278/1 <br /> g Approval No.100-10161 Emergency Contact: 510 634-6850 <br /> c <br /> 'Z 10. GENERATORS CERIIFICAMN: f hereby deck"that the Contents of thb corviif rant are fsray and actual deacrbed above <br /> Packed,rnoked od knelea,and me n d r s n pope'.comm,f,�t t. tri Proper shpp'srp rmw and are Ckmf"ed. <br /> O n+F prape oapari pY h'q`way oCacn>rp to rCpEc3Je'r4ewin onmand rv".ors�pa..srrrrve!J ublan <br /> r 8 I am a lope gwday gererator,I tarty that I have a program h picots to reduce the vokme and toldcay of waste pQneraled'to the degree I have dNemrwd to be <br /> ZecohaffVCc*Y Practicable and that I have selected the piactr.•able method of}re WrrwrM,>fonoge,or deposal currently aeoiasle to rhe which ff** iza ttw present and hA" <br /> Sty threat to huran health od 1M ervkoorort;OR,E I am a smart quantQy gehealo,l have made a good lath effort to mitkn®rrry wade genoradbn and wieet the peek wort, <br /> r rnonogemeN method that h aml ble to hre and that I can afford <br /> J <br /> Q Pmtea/lypecl Name Siw m re Month Day Year <br /> U 1 <br /> a 1�� Ak <br /> H T 17.Transporter 1 Pskmwledgement of Receipt of Marmara <br /> p> R Pr,,tedrypedl4mne 'Yo <br /> Ye <br /> U N aa /�, <br /> w S - - /� IZI i1 V1 41 1 <br /> 0 18.Trons57War2AakrovAe rent offbw dMdemis <br /> R Printed/Typed None SgnaN+eI Monro Day year <br /> w T <br /> 0 E <br /> �+r R 1 I I I I <br /> 1 Q cy F 19.Docrepo ksdcotion Spoce <br /> U A <br /> Z C <br /> I <br /> L <br /> 1 20.Faciry Ow rwr or Operator Certficatim of receipt of ta[a taus maferm;carred by the marfteit except ar hated in aero 19. <br /> T Pmtetl/fypea Hgnw Monro LkDayo <br /> Ye <br /> Y C•C.> L .. <br /> r Signghse if 12 <br /> DO NOTWRrrE BELOW THIS LINE p FJA I—26—a 2 <br /> DM e021A(12/90) •1 Yellow: TSDF SENDS THIS COPY TO GENE <br /> EPA 8700--22 <br />