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.)r N, t;r ,:>-28-9• 1:t:22 :G I BSON ENVIRON:YE+iT_1L�'rESORO STKN TERMINAL:# 2/ 2
<br /> forM s0prernd Offil No.2050'W39'(Eapire-t 9•30-9e) Sao InsirvLlions on bock rt '--3cc b, peaa.,,nero of Toaw Substances Cam
<br /> P.•,;"print or type, form dtow-id for uta oe elite(f2p,K. .rrrev. Sacrommto,Colilomi4
<br /> UNIMRM HAZARDOUS 7ZO�L—L-
<br /> ors
<br /> r't US EPA ID No tilari}e:t Do urnan Z, co3a t Information in tfle shaded rnect
<br /> r WASTE MANIFEST 0 0 16 11 $ 6 3 7 8 1 Lq /� it rwt rcgwred by F,.derol low.
<br /> J _ � �_j.�� ` 0of Name and Moiling Address A, Suety
<br /> , 1..�~•. AAa.Mf'e*wxac-D..�'o:a'�m"so,..tiNu
<br /> m•b"e�7r
<br /> 1 Ti?=oro Petroley12 8
<br /> 30 3 Navy Driver Stockton, CA 95206 6a « ID 3VR�.i.r
<br /> 4 re. 0e4vprr Phone 207) 466"8800
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<br /> d s Yrarcp rte 1 Company Name b. US EPA ID Number C. slow Trwapot}e{e
<br /> �rickscn, Inc. A D P 19 114 6 13 .19 2 0. rtatrtp�t,.rt rha.. IS10 235-1393
<br /> 7, Transporter 2 Company Name 8. US EPA 10 Number Z. Sia»Tronrpprtu's ID
<br /> U f
<br /> f 9 DesiQrtaiad Fa(r6ty Name and Site Aduress 10. U$EPA ID Number 1 G. State F-jdWs ID
<br /> Gibson EnvH-rontrental t
<br /> JA Nci 2D.
<br /> cc-m Tercial Drive
<br /> !U Sakersfiel.d, CA 93308 P A P 9 ;8 108 18 13 11 J 7 ') -0413
<br /> s 1018 18
<br /> -1 13, Total It, Unit
<br /> I I U3 DOT Description(including Props. 5hipp,nQ Noma,Hazard Clots,and 'D Nurncart
<br /> Z _ No. Type I Qvpn! Wt/Vol I. WnW Nhttthe/
<br /> I Ssoto
<br /> Rq, fiazaw3ous Waste Liquid, N,0.S, i � 213
<br /> ORM-E 111"9189 D018 1 i T i T �/-6r0f G I ;pAICttrr D018
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<br /> R 4 1 � EPA/OlYw►
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<br /> 61
<br /> `-) t I {FPA/Otho
<br /> z I J- Addifienal Descriptions for Akaftrials listed Above ^'----- -- ---- tL Handfinp Codes for Wastes tined ASow _
<br /> it �Oi l 1-5a o. a � h.
<br /> W water 60-75%
<br /> Sludge 5-20%
<br /> 0 I 15. Special Handling Initruet;wl oM Additional Infcrmation - _ --- - --
<br /> Gloves, Respirator ERS, # 31 Pr��lle 153222]
<br /> z
<br /> Erergency Contact: Dave Taylor No. (209) 466-8800
<br /> 1 le. GENMATOIUS CERTIFICATION: I hereby decbte That the contents of the consignmem are folly and oc000taiy desuibed above by prcper shipping -.am# and are t1050180,
<br /> IIS packet,mocked,orsd le a",aid are in all respects in proper condition for transpo•t by highway aceora:nq to oppf.ceble federal,state and internationa!'awl.
<br /> 1 I or a large quantity generator, I cervrf) *at t ha.e a program in p!o<e M r•dv<• the volume and toxicity of wmte generated to the depr•+ i hours Arttermw+ea to he
<br /> f ecerurr�icaSf prac+icable and that i have selected fns practicable method of heotmenf, storage,or disposal currently nvoilable to me .high minimises the pretsnt and future
<br /> yLLj i rbreot to human heohh and the en.iroaoserrt; OR, if 1 am a 1007l quantity genero,or, I he.e made a good faith effort to Tri inirmse my wase genevoticn and select the best
<br /> waste mana�ornom rretl-cd that iii uro'eable ro me and that I can cffwd. _
<br /> i f inil.d/Typed Nome Signature ,�y� ,.�' N!orssA Day to
<br /> I ! 4/,2>
<br /> Z / i 17. Troreporitr ACY tnwlfd7c a. Recnot of Miler oh M / -
<br /> Pii g'.ed Name — $ N -a•s— -----'�---rui Coy Tear_
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<br /> r1, � IS. TransTrarxr,:Ackrrowle
<br /> W T ?r,nted/Typed flanse Month DcY
<br /> year
<br /> u. it 1 1
<br /> w 19. f3srreponey�cf calx Spoce
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<br /> z� C
<br /> -! �_r'auLtr 1J.nsr_sr O�fnrornr Certi<iconaWoi rrceipf of hezortfar, n?tinal:Bowe•.-A by this ry,a ife were ut.no!�d
<br /> - —T,-- Fsamh D,, Year
<br /> T , Pew edfTsped Nome ,� y,o ire Y
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<br /> DO NOT WRITS BELOW THIS LINE.
<br /> While, TSDP SEND5 TH!5 COPY TO DTSC 'WITHIN 30 DAYS.
<br /> DTSC tC:'ra ,'.7,91) To: PO. Ban 3000, Soc.orrento, CA 951312
<br /> EPA 87 OU--•41
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