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Slone of CoFlor Environmemal P orerLan Agency
<br /> Approved OMB No.2050-0039(Eapres 930P9e( See,ID5fTULf10D5 on bptl( OF page b.. Departmenhol io.a So! o cm Control
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<br /> UNIFORM HAZARDOUS 1. Genarmori US EPA ID No. Maniiesl Document No. 2. Page 7 Informcfon'n IFe sha, n
<br /> WASTE MANIFEST `aar'roared t Fede II
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<br /> pO 5. Transporter I Company Name 6 US EPA ID Non.ber t y Y
<br /> EVERGREEN ENVIRONMENTAL SERVICES ^ y
<br /> CAD980695 761 ° gQ Q4 `
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<br /> QL-Tro^sponer 2 Company Nome B. US EPA 10 Number
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<br /> l"I Z Y. Desgnoted Feistier,Nome ental Sue Address 10,.US EPA ID Number. - ^
<br /> d W EVERGREEN OIL,INC: $g Q 4 L rx
<br /> 0 6880 Smith Avenue m
<br /> Na Newark,CA 94560 CAD9808874711 A T O
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<br /> O IS Speciol Handlin Insfmceons and AdditionalIoformafon e c
<br /> Wear Rubber gloves 24 hour emergency response 510-795-4400 Emergency contact-Kirk Hayward DDTGuides127
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<br /> 16. GENERATOR'S CERTIFICATION: t hemb,d«lore that rhe conieon of M ni,nmenr are fully and accurately deso'bed above by proper apping acme and are clouded,-.
<br /> Gp ,ked,marked,and labeled,and are in all reipimch in proper condo far t.+sport by 6ghea y acs lona io.,,d cable lede.al,stun d- t nation ws.
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<br /> J I IK I i g q .not, gent,oror, I sen fy that I h ......m pi I reduce the volume d t l, 1 t q i d n thed 9 I h d r - ed'lo be
<br /> IN p acticable and that I have salrx,ted the procTicable m b d 1 a.marart, n age or da,rceil eararafl, y,alcilbl,r 6 h rnanamar,i the p I d fence
<br /> Nth m t human health and Me en ' nt OR 'f I mall quanny gene•ab h e made a good faith ellen t ze my waste genemran and select he best
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<br /> ° Printed/Typed NamF - Stan. r Month. Day Year
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<br /> . er 1 Acknowledgement Receipt Reor ofMaterialsi
<br /> Primed/Typed Name S,vamre ,00nth Dav Veer
<br /> `Z• 0 1R. Trans rte'1 Acknowled einem of Reser t of Materials I
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<br /> 03/16/1998 "ORIGINAL MANIFFi'.
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