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State of Celiforruna—Eryironmentol Protection Agency -
<br /> -. Form Approved OMB No.2050-0039(Expires 9 30 94) 'SCC IOSfTUQh005 00 haCl(.OP page b. Depodme n of To—
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<br /> ..UNIFORM HAZARDOUS f• Genemmr's US EPA ID Na. Manifest Document No. 2. Page 1 lormot tr leaded
<br /> '. WASTE MANIFEST Jr not r q dby Fede
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<br /> 3. G .vtor's N d Mailin Add ss A.Stale A+ori Qa acere t Npmbcr ''< "�h
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<br /> pO 5. Transporter I Company Nome 6. US EPA ID Number
<br /> Q? EVERGREEN ENVIRONMENTAL SERVICES m r
<br /> CA P 1980695761
<br /> Q2. Transporter 2 Company Name 8, US EPA ID Number Ed=61p19 T/ / rsg� + .
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<br /> Q 9, Designated Facility No—and Site Address. 10. US EPA ID Number �J4ff F6esGIyA'1D ' d - � y
<br /> EVERGREEN OILLID 0 , INC. ax �ad
<br /> LL 6880 Smith Avenue rt raaruy:�n Fq;
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<br /> a Newark,CA 94560 C A P 0 0 10 18 18 17 14 11 18 �"' , 1,
<br /> U12 C ntdner 13, Total 14 Unit
<br /> 1 ti.US DOT.DescrEfion(including Proper Shipping Name,Hazard Class,and ID Number)
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<br /> N E NON-RCRA HNADOAUASA , LIQUID 00 T
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<br /> O 15. Special Handling Instructions and AddhPonol information _
<br /> IN EMERGENCY
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<br /> w 1-800-424-y300
<br /> s DOT ERG 31
<br /> 16, GENERATOR'S CERTIFlCATION: I hereby declare Mot the currents of the consignment are(ally and accurately described above by proper shioainq name and are ylavd.Pd,
<br /> Qpocked,marked,and labeled,and are in all rirspsu u in grope.coadiu.far transport by highway aaordlng to opp8cablefederal,r,aand internmima'lows
<br /> If I a a large q entity geaeaw." I certify Mot I have a program in place to reduce the volume and toaidy of rate gene ated a he degree I have derermmed to be :f
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<br /> economically practicable and that I have selected the pradicable method of treatment,storage,or d sp sal currently l 64,Io me vohkh.munarnior,the pirese.t and future
<br /> M eat to human health pad the environment;OR, it I am a smell quantity generator, I hove made a good D,44 effort to m my wouP, generation and select the best
<br /> 1 3 veaste-management method*at is available 1o=and that Icon afford_
<br /> IO Printed Ipred_Name Sgmonv — -M Ih Day Y
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<br /> Z T 17:.T rtee I Acknowledgement of Receipt of Materials _
<br /> q P,nt<i /Typed Name Signora ! —1-Znm Day Year
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<br /> 18 Trans,ower 2 Acknowted ememt of Recei t of Mater els
<br /> w v Prmed7Typed Name - $gnu !e Momh Day, Year
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<br /> I F_ m- If r Ceo+fyIcur far ho,o r1 n material, ered_b�thlo _ept a5 edv Item 19. —__ I
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<br /> DO.:NOT RIT BELOW THIS LINE.,
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<br /> nr a it ,TSDF SENDS,TNIS COPY..-TO UTSC WITHIN 30 DAYS
<br /> DISC 8022A (7/92. ,. – in "J, llax KW, 5.P,run< to, CA 95812
<br /> EVA 8702--22 .. ,� b
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