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Aug 28 06 11:17a Julie Huber 209-668-3880 p.2 <br /> I 51a2e of Caibmia--Emironmenbl Praledian Agency <br /> Form Approved OAU No.200-003 (F.vairV 9g j 8"P1 See Instructions on back fp0 a 6, <br /> Please pi6�rgFomr derlgned sere one Md(llpikAl OTewvihr. DopmenersldTosic Subaanra Can". <br /> Savmnenlo,California <br /> 7� � <br /> IFORM HAZARDOUS 1. Wnembls US EPA D No. Manila)Oacument tJa. 2. Page I In(ormati0n in rhe shaded aroa <br /> WASTE MANIFEST 7 8 s not required by Federal 6vr. <br /> OF '1 <br /> ear'e Ncros and Meiling Addren <br /> AMERICAN VALL-=y !A-IA—STE OIL WC A. Stora Manifest Document Number <br /> oP.O BOX 340 <br /> 24716141 <br /> lar's Ph on. tlll� /31-0Fi4b UELH1, l'A Ub31y S• .Gn.raafabarhrl Coapory Nang 6. U5 EPA ID Number CSIale Trans parws l0ljte ved.l <br /> psr�nu sins • yr seen r�rr^ap. iranpaleYs Phone nne1\WKLY V^,-� .o YYIUJrL Vis ,� �I f� 7rbr2Camparty Name. 8. US EPAE. Sat.Transpner's ID ReseF. Tra.sp0rsefs Phe. <br /> .d iaciliy Noma and Sib Addrea !0. US EPA ID Numhx G. Sbb Fcilks•'s ID <br /> COa6ANK UIL IHANJI-Eft w <br /> 5300 CLAUS RpAfl H. Fxifi a Pla. 7 <br /> RIVERBANK CA 95367 119 d 209 63 <br /> �a inn 11. US DOT Deeari nduding Proper AiPPing NomHomrd Claes,and ID Number) 12. Conlin"en i3. Tobi Id. Unit <br /> C,lL P I. e, <br /> Z a. No. T e Ouamiy WWd 6Wa81s Number <br /> M. NON-RCRA HAZARDOUS WASTE LIQUID Stab <br /> 3 G i USED nit 221 <br /> T f G EPA oo-r <br /> E b <br /> m E State . <br /> A EPA/Oder <br /> <. <br /> C 0 stmt <br /> w <br /> R EPAJOdw. <br /> 1- d. <br /> Z score <br /> W <br /> U <br /> w <br /> . EPA/Ofheh' <br /> y AAddilianal Doo iprlons For Materials Usld Ab.. <br /> K. Handling rads For Warps Usbd Abvn Ia3:r'• <br /> USED OIL:&WATER p ° 09 b.. <br /> J c d. . <br /> a <br /> 0 15. Spacial Handlingimvudions and Additional informauon <br /> N <br /> Z GLOVES <br /> = EMERGENCY PHONE 209-667-8857 <br /> ld. GENERATOR'S QRTIFKATION: Thereby declare that the mnfenb oFlhis mnsignmentorofuAy vnd atturahly desvibed above by proper shipping name and on cloviPrad,pocked, <br /> V marled,and labeled,and oro in oR rmp.ds in propx condirbn Far transport M highway oocerdng b appliooble inhmolional and mond govemmenl regulalims. <br /> If am a large gaantige.roloq I cersiFy diol l hove a program in plan b reduce 1M volume and fozkiry a(wash generated le tM degree hove detenind b he ecanamimH <br /> ydj preckable ad that 1 hove selected the 6=66 malhad of tnalmant,storage or dispaal wantwly.v &ble*me.which minimizes tM present end Fu,,threat b human h.21 <br /> and the mvir.r.m;OR,iF I am a 1-011 quomiy genarebr,1 hove made-9--d fo11h e1Fan to minimize my wodn garwaf..and select the bat wmh mamgement method d Qj is <br /> O ..gable to me and that I em afford. <br /> } Prinbd/Typad Nam. 5' Iwtura <br /> 4 µan Day Ty <br /> W our #4-0 —T I U <br /> U 7 17. Trow r 1 Ack einem eF eacsi d Materiels <br /> w e Prime /Typed Name signanua <br /> R fdPn1F) Day law <br /> W P L X ClY/09^r L/• I <br /> n TO. Tram porter2Adnowld vneM of Rem taf MofWals lJ <br /> O T P,m1d/Typed Name S' .t�re <br /> y A g i Month. Doy Year <br /> Q <br /> U F 19. Disvepoocylndio.H.Spac. <br /> Z A <br /> C <br /> I <br /> L <br /> f 20. Facility 01xC roar Cenihcad of ree.i -1---end-,maledd.<overed h Ihtsmani6tt ez<W On 2w. nlam 19. <br /> T Prinld/Typed $ignarvn v Man1hDa Year <br /> L3 1, y, CJ <br /> DO NOT WRITE BELOW THIS LINE. <br /> Yd6vc TSDF S24DS tris _G%Y rC CiC;4_1b,(C4 0:111-IN ?0 DAYd. <br /> DTSC 9022A(1/99) IGmmruwn .,L.. n :. <br /> ii lis J.:c :miq:�t Om '....iv:�. <br /> EPA 87M-22 _ruu�c: cw q..:r::�o . ..:I 16 i.. .Op, ..ul r.�ro 'o D751: —id, J:' days.) <br />