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Aug 28 06 11:27a Julie Huber 268-3880 p.28 <br /> -9-30y <br /> Form Approved OMB Ne.205D-0039 IEnpirm 9-3G-99) - See Instructions On bac age 6. Department of Ta.k Subrlonces Cont <br /> please Pnnl ortYPrFamrd"Ained fru se on elite A 2-plkh)typewrikr. ��n Saamneeto,C°LkrOia <br /> UNIFORM HAZARDOUS 1. �nRp1or's US EPA ID No. Moniinl Dccomant No. 2. Pogo i Inb•mction in Iha shaded arem <br /> WASTE MANIFEST � A 1 0 1? i7 132 ' f "m'requldbyFederallow <br /> 3. Ganerelor9 Sh,mr. als.311 LAAN VALlj-7 ARU Ic )IL iNG A. Slate Manilast Docvmwl Numb.- ��v <br /> PA)f3Ok 341.1 <br /> o <br /> DELI-Q. (»+1,f3b316 B. Store Gener°belAD <br /> vI A. Generator's Pho QGD M'(..GaGI <br /> n <br /> h5. Tromporler 1 Company Nome 6. US EPA ID Number C. Stole Tmnportor's ID[Reserved-f <br /> ow' Ahi M- 1 4AN VALLE'V 'MA51-E 411. E. A L 0 'rS 0 $ D. Tgmpone(sP o J <br /> 0 <br /> 7. irons crier 2 Ccm rtNorm P PaY 8. JS EPA IDNembv E. State Trcnsportar's ID IRme„ef r <br /> V_ ?. Tsanspo-ter',Phone -. <br /> 0 o d <dress ao 10. US EPA ID Number G sole foci INs ID Q. e�.€I�iNr' Ji'�:�'�d <br /> :0 F <br /> z ,RAID CLAUS ROAD H. a iliy',Phone <br /> �•� 11IVh:(tf31'-lNA, f'A:UXI I A I- 1010 !0 It 14 10.1':11 ii 209-803--31111 . <br /> V V 11. US OOT Descrlptian firrluding Roper Shipping Nome,Hezerd Clom and ID Nuri 12. Conkimrs 13. Taro) 14. Ur@ <br /> Z o. No. Type Ouontiy WN/V.1 I. Ware Number <br /> i Lw LwkuIt) Slate 221 <br /> I — <br /> C {LLLvm �pILj \ <br /> E 3+ t.11 1 J I V '1 <br /> 3 L) EPA/Other <br /> N <br /> o <br /> N. <br /> m E <br /> v R i EPA/Other <br /> < A <br /> o T smt. <br /> m O <br /> R E? Other <br /> s <br /> F d. <br /> Z Sole <br /> W <br /> V I EPA/01.., <br /> w <br /> 1. AccliKowl DesviPlioro br Mararicls❑sNd Above K Handling Codes For`Nostes 1.41ad Above ... <br /> USED OIL St WATER 0,1 b. <br /> w <br /> C. d. <br /> a <br /> Q15. Special Handling lnstrucriomand Addifiana,Infarnmiw <br /> GLOvR; <br /> Z FFJIELs1I.:EN(2YP. ONE20! 607.E851 <br /> z <br /> Q16. GENERATOR'S CERTIFICATION: Iheroby dedare lboltm mnlmis aFtAis wnsig.mens ore l°ly and accumld described Dawe by paper shipping nano and are dossi(iad,pocked, <br /> V mvked,and labeled,and ore in all respects In proper andilian(or Ironsport by highway a<ccrding to app�wble irrornaFon<I and notionagnrernma�t ragulaliam. <br /> if 1 am a Iarg q+onfiy generator, 1 arfily that I have o prog+am in plea to reduce the volume and loaieiy a(wosk generated to the degree I have determined to be ecoromiall <br /> a ractkabla and that 1 hwe seMad the rwicabie method of yy <br /> h P Irh o e a srogo or disposal currently ovarhy ro i which minlmims the present and hilum thrrm ro humon heath <br /> and the avironmrd t OR,ff I om o oma I quamiy gemralw,I how made o goad faith effort ro minimim my wvsta ganarotian and selxv IM 6esl was:>monagamanl meshed Ihol is <br /> O aroilohla to nr°rid shots wn offered. �3 � <br /> V Primed/Typed Na 1 ^ $ignalura onth� <br /> w <br /> u N 17. lir.aNpomer I Apkmiodganaarl of Rhiept of Moterids <br /> w A PrimdlTypd N me Si elute / /gn>h1 My6 `(�. <br /> W 0 78. TraOR <br /> m rler Acknowed emenl o°Raeei o(Makrids <br /> T Printed/Typd Noms Signmura Mcnlh Dov yaor <br /> W E <br /> Q <br /> V F 19. Discrepanq Indkalion spam <br /> Z A <br /> C <br /> I <br /> L <br /> 20. Po . Owner DRO arolar rldicoli 'regi of hasardow materiob averd this mon' sl axce res noted in Ilam 19. <br /> T Primed/Typed o SigmNre Month Day Year J <br /> • DO NOT WRITE BELOW THIS LINE. <br /> OTSC 80 724 11/99) .. -. . . <br /> EPA 87DO-22 .. <br />