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<br /> form A,p,..d OME No.7050-0039(L,1...9.30,96) See Instructions on back of page 6. D.,.'Praml of took Sub000rn Com"cl
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<br /> 1. PA Ain ID No ...I'd Document No 2, age fbamsmrm;; .the graded area
<br /> UNIFORM`HAZARDOUS P,Act by Federal
<br /> WASTE MANIFEST 7-
<br /> 3 Cre to Nome and M.hing Add,j,, Slat M.0 Dixurniorot N.mlbo,
<br /> 23842T
<br /> Az,' '96
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<br /> 3.'.Tn.Pb.0.r I Camp.,Name 6 US EPA ID Number C 5'al.Tneagarcl.,"ID I
<br /> EVERGREEN ENVIRONMENTAL SERVICES D Ph,ma,
<br /> I VIII 191 Al 2141 11 a1.2Lfij-Z -(8800 32252283
<br /> 7, T,.n,W.,2 Ciuop.o,Name 8.,US EPA ID Number Stage Tcm,,.,I.,'s ID
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<br /> -::j- 9, D.,J,.rzhd1 Facility Name and Site Add,.,, 10 US EPA ID Number G. 51.1,1 ID
<br /> 000 EVERGREEN OIL,INC. I-LB-L71A-AAL--�
<br /> 6880 Smith Avenue H, FicJdy'ph..
<br /> Ncwa*—CAMO 8ALT 8 _ff-I -T9 5-4400
<br /> U 12 Container, 13. Total 14 Ur,.' "e
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<br /> 0 J.'Addificincil De.nifitors;for Magi Wild Ab .. K. Hcmdba,Codes For Wcates,Listed AbuCy
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<br /> 0 15 S,rml Handling In,trucnane and Adchtan&Inlormmion
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<br /> < 24 Hour Emergency Response Telephone No.:CHEMTREC 1-800-424-9300 Invoice► J'
<br /> DOT ERG 91 WEAR PROTECTIVE EQUIPMENT
<br /> 16. GENERATOR'S CERTIFICATION. I h,mb,declare that the contents of this consignment are fully and accurately described!above by proper ithapniq narne and are disinfect,
<br /> <1 P,zck.d,marked,and h.1beled,and are us all...aeca in Pioser condition for transport by highway according to ct,,britbi,mle,acti...I and ison.o.1 goven-mii.
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<br /> If I am .large.quantity marnimr, I certify that I hats.cz ...gram P. place to adisre the H,I.me and to.aiy of waste generated to the degree.) have determined to be
<br /> uncraccrit, prorsuable and that I have,elected rhe practicable method of vestment,storage,or disposal currently available to me which minimizes the present and future
<br /> ih,..,to human health and the in,instrourb OR, if I zon.go.101quarifity generator, I hove made a good faith effort to minimize my waste generation and select the best i
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<br /> vitsh,management method+a,i,available t.,am and that I an Ilford
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<br /> DO NOT WRITE BELOW T LINE.
<br /> i W tnfe TSOF SENDS THIS COPY TO DTSC 3C 0A 1,
<br /> DTSC IMP 0,95)
<br /> To! P.O. 954)2
<br /> EPA 8700-22
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