Laserfiche WebLink
NCY'l-HAZARDOUS WASTE MANIrEST <br /> EES19 <br /> NON-HAZARDOUS 1.uenerator's US EPA ID No. DManifestocument No. 2 Page 1 <br /> WASTE MANIFEST NH 4663 of 1 <br /> 3.Generator's Name and Mailing Address <br /> sWu , <br /> CA 01453-1'1 <br /> 4.Generato>" Phone( ) <br /> 5.Transporter 1 Company Name 6. US EPA ID Number A.State Transporter's ID <br /> I <br /> EVERGREEN ENVIRONMENTAL SERVICES I CAD982413262 B.Transporter 1 Phone 510 795-4400 <br /> 7.Transporter 2 Company Name 8. US EPA ID Number C.State Transporter's ID <br /> I <br /> I D.Transporter 2 Phone <br /> 9.Designated Facility Name and Site Address 10. US EPA ID Number E.State Facility's ID <br /> I-ALA <br /> Q -0C7 <br /> I EVERGREEN OIL, INC. F.Facility's Phone <br /> 6880 Smith Avenue <br /> Newark, CA 94560 CAD980887418 510 795-4400 <br /> 11.WASTE DESCRIPTION 12.Containers 13. 14. <br /> Total Unit <br /> No. Type Quantity Wt./Vol. <br /> I a. <br /> Non-Hazardous waste, liquid P <br /> 001 TT G <br /> G b. <br /> E <br /> N <br /> E <br /> R c. <br /> A <br /> T <br /> O <br /> R d. <br /> W <br /> H <br /> G.Additional Descriptions for Materials Listed Above H.Handling Codes for Wastes Listed Above <br /> Cn <br /> 0 <br /> 0 <br /> ccQ <br /> Q15.Special Handling Instructions and Additional Information <br /> _ 7�aF Invoice: 3�Z ) <br /> Z' Profile# ] Sales Order: 17-44.1 <br /> Do not ingest <br /> O <br /> Z Wear"ase <br /> rotective clothing <br /> mergency call: CHEMTREC 800 424-9300 <br /> 71 <br /> Jilin <br /> 16.GENERATOR'S CERTIFICATION:I hereby certify that the contents of this shipment are fully and accurately described and are in all respects <br /> in proper condition for transport.The materials described on this manifest are not subject to federal hazardous waste regulations. <br /> Date <br /> Printedrryped Name Signature Month Day Year <br /> TR 17.Transporter 1 Acknowledgement of Receipt of Materials Date <br /> APrint yped Name / Sign tte Month Day Year <br /> QFBI,Transporter 2 Acknowledgement of Rece" t of Materials Date <br /> TPrinted/Typed Name Signature Month Day Year <br /> E <br /> R <br /> F 19.Discrepancy Indication Space <br /> 20.Facility Owner or Operator:Certification of receipt of the waste materials covered by this manifest,except as noted in item 19. <br /> L <br /> Date <br /> T Prin yped Name Sign r <br /> Y � "7Day Year <br />