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I - Slide of Caklamo—Fnwomm�wd Prorw,—4
<br /> Form APP•o.ed OMR Ne.iV50 39,E,p"n v?ase; See Insirtucrions on back of page 6. oePo.,mem nr m.;.sum, cem•a'
<br /> - nev+e Fuel,or ype. Form deeyr.d f,v,e our etre(12",f)ype—.r. -
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<br /> WASTE MANIFEST s.wr reqs red by Fed
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<br /> ( "A°'^� o State l.bn7nf 6. resist Number
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<br /> O 5. irons pert..r I Company Name 6. US EPA ID Number I C. Store Transpona/s D ,..-l.,
<br /> 1 EVERGREEN ENVIRONMENTAL SERVICES
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<br /> 4II ]r T,.I 2 Company Name B, US EPA ID Number E. Slme Tmnsparte,,ID
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<br /> Z j 9. Devgnmed Fa<iliy Name and Site Address 10. US EPA ID Number G. Srere f«ihj s ID
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<br /> 11) 0 EVERGREEN OIL, INC. IC[AID191810 (8181Li4 118L
<br /> c0 A. 6880 Smith Avenue
<br /> .Newark,CA 94560 CIA ID 19 IB 10 I B 8 17 4 1 8 y Ph M (510)795-4400
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<br /> 1 Addtwn.l Deanperons for Miner oh.Used Above --- g Handing Codes let Wismes Wed Above
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<br /> Q1 15 Spec,ol Hondhng I"true on wed Add+ Informoton
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<br /> a IN EMERGENCY
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<br /> CALL CHEMTREC x
<br /> w1 1-800-424-9300
<br /> � DOT ERG 31 WEAR PROTECTIVE EQUIPMENT
<br /> 16 GENERATOR S CERTIFICATION. I h by deI th t he ome,ml of 11 g m fully "d oc t Iy dar,,nbrd Ius,by p p h-pp p d to 1—used,
<br /> Q po k d ked o"d mbeled,and or, ell respects itsp,.,-rcondo on for pompon by high.....cord g t opplicabl t —t.ur.l Tod nnf.nel gevernmert regul.+ons. I
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<br /> P�t+d/Typed Num s j. d ax Jt S g N /J//may t -Month Do, ye., -
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<br /> " �,'i13G ''+ .1',Tl,DO, NOT-,,WRITE BELOW.,,THIS.LINE ti
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<br /> wt,+e TSD= SUNDS Thi, COIP, TC, to -.;.W,uur ;n ons,
<br /> DISC 8032A (IY95) To P.(J. 0 3L30CI,
<br /> flr B7G6-12 rs
<br /> a 1 .,.I ,M1 ,li 14 ,C
<br /> 03/16/1998 -'ORIGINAL MANIFEST COPY'
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