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10— 2-06; 4:49PM;YELLOW ;913 344 3614 # 14/ 33
<br /> •Aug 28 06 11:20. Julie Huber 2C48-3880P.1 I
<br /> Sxxe ofColilanio--Emiiurimenlol ProN Hd Agency ac '
<br /> Form.4p". B 14.,,Mp-U019(Expinl m99J A See insfrualiens on bark of page 6. D.pa•Imentar Ta>;e sob„anr„e,�,el
<br /> 'Pivme prim or ype. Form don§rmd hr ms m eFl4 F!1-pimhj rypewrimr. $aram.nb,Cal,fam:a
<br /> 1.Gmmaror'r US EPA ID No., Moro Demm.m No. 2. Poe. 1 Infvrmaion:n rh.ahodd a.eoa
<br /> UNIFORM HAZARDOUS C A L 0 '0 0 8 2 7 8 78 h 1 boat r.a.ird by F.deral lw..
<br /> WASTE MANIFEST ;
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<br /> naratorr,N_and ATailirlg Addrats AMERICAN VALLEY WASTE OIL INC A sole ManiFepO vmmt Number
<br /> P.0 Box 340 23793830
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<br /> V 5KME440A"'i.lure.-T#4 srEH IO. US EPA ID Number G. Note fLpcili ale V 0 ,
<br /> cv)Z SWO CLAUS ROAD
<br /> CT)o RIVERBANK,CA 95367C 1 89 f I
<br /> s• Pady �3 8181
<br /> ID Num
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<br /> 0 15. Special liending lnrlrucrlons and Addtaenel lnlermafan •},• '
<br /> 1— GLOVES
<br /> z EMERGENCY PHONE 209-387.8887
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<br /> 10. OEMRATOR'5 CEVIFICA71ON: Iherebydeclory rholdu emfenL aFlhis eenai8nmmr ace fvlfy and oceurwd.acribed abava 6y proper ahippne nam.=ndon<lanifled,poekvd,
<br /> ill U marked,and labeled,end...in all ra,pah in proper midiv.Far Romport y het,, y ac<adirq to applicable srxernafenal and rrode.e Hoeommenl rpulaGen,.
<br /> Il:am a large cl rfip grorolor,I aertly that
<br /> I hose a pragrani in plan to mdum the whim.and toxicity'oF wale gmaroved to the degree I hma debrrafned to ba aczmmiaolh
<br /> a praaimhle and
<br /> dmt I how Wooed the motleable method oII baalment,garage,or disposal currendy modab4 b no which mivnizm the",saland let.threen b h...,heeld,
<br /> end IM ma ingr01enl;OR,iF I am o small quaMy 0...mlar,I how made.good Foilh edea Ie minimi:.my wao.gams , and 4.0 iM hes wool.managmmi metiwd That i,
<br /> available to me and that 1 con afFard.
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<br /> W T 17.T niter I Aekno nt of Rece' of Ma.,a
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<br /> o,hacarda mmeRals<avaredb Ih'v..1 I'd exactor neMd ie Item 19.
<br /> Pdnled/T d S:g«wro Aeomh Dal Year
<br /> DO NOT WRITE BELOW THIS LINE.
<br /> ' Yellow: TSDF SENDS THIS COPY TO OENEiATOR WITHIN 30 DAYS.
<br /> IGenvwla,n who a.bm11 n.zorJo.s ,cm for uonspan awrol•gae,
<br /> DISC 2022A 01991, prodvre templet ti copy of nis cop, one amd m"rwitn,.30 dopJ
<br /> EPA 9708-22.; '
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