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State of California—Environmental Protection Agency <br /> Form Approved OMB No 2050-0039(Expires 9 30 99) See Instructions on back of page 6 <br /> I Please print or a Form P 9 Deportment of Tonto Substances Control <br /> p h'P desegned For use on eft J 2 pitch)typewriter <br /> �� Sacramento California I <br /> UNIFORM HAZARDOUS 1 Generator's US EPA ID No Manifest Document No 2 Page I Information in the shaded areas <br /> + u not required by Federal law <br /> WASTE MANIFEST —73 '� { of <br /> nerator s Name and Marling Address 4F3 <br /> RPETRO, INC.50 EL CAMINO CERES, CA 95307 t °, <br /> 4 Generator s Phone ) Y <br /> 5 Transporter I Company Name 6 US EPA ID Number l c r <br /> 00 „ <br /> o ALLIED PETROLEUM CAL 0 0 10_11 1112 3 1 4 17 w <br /> 7 Transporter 2 Company Name 8 US EPA ID Number A ri , <br /> E. <br /> Q GKOW r(e'i ° 0 s rf <br /> V 9Aae LN,am$AL.Sre Address 10 US EPA ID Number � t " <br /> IC <br /> 2570 ALMOND DR. h . <br /> SILVER SPRINGS, NV $9429 IN IV ID_19 8 2 3 5 $ 14 8 3 + <br /> 5 ,r <br /> Y <br /> Qnrt x <br /> I 1 US DOT Description Containers 13 Total ld U <br /> on(including Proper Shipping Name Hazard Class and ID Number) No Type Quantity Wt/Vol II - pile U e <br /> NON RCRA HAZARDOUS WASTE LIQUID <br /> f <br /> E { T T G <br /> O K <br /> W N b a taY <br /> oo E 9 <br /> Q R _d <br /> A <br /> T rs! ` <br /> co O <br /> R RA'a+ e r <br /> d <br /> t It e F 0 ed o <br /> .x l�Y C}! <br /> W =r <br /> f <br /> 35 Special Handling Instructions and Additional Information PICK—UP AT: 749 E• CHARTER WAY F - <br /> `a WEAR PROTECTIVE GEAR STOCKTON CA <br /> Z 24 HR FACILITY 702-577-9001 ' <br /> 24 HR GENRAT 209-537-0771 <br /> Q16 GENERATOR S CERTIFICATION I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified packed <br /> V marked and labeled and are in oil respects in proper condition for transport by highway aeeordtng to applicable international and national government regulations <br /> If I am a large quantay generator I certify that 1 have a program in place to reduce the vafume and toxicity of waste generated to the degree I have determined to be economically <br /> practicable and that I have selected the practicable method of treatment storage,or disposal currently avada6le to me which msnim zes the present and future threat to human health <br /> and the environment OR if I am a small quantity generator I have made a good faith effort to minimize my waste generation and select Ilia best waste management method that+s <br /> 0 available to me and that I can afford P <br /> Printed/T a eine ! Signatures J/ Month Day Year lk, <br /> f^ ]] 16 ' fr ) 3 U - I q <br />(.D8 17 Transporter 1 Ackno-leciciameni,of Receipt of Materials <br /> a Signature Month Day Year <br /> N Printed/Typ <br /> L, <br /> 0 18 Trans Drier 2 Acnowled ement of Receipt of Materials <br /> TPrinted/Typed Name Signature If Month Day Year <br /> LU E <br /> F19 Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L <br /> 20 Faci Owner ar O orator Certification of receipt of hazardous matenaIs covered by this manifest except as not in Item 19 <br /> Prins / yped Name ` Signatur �. Month Day Year <br /> _ ! G 1��U r ✓`rig ,/ ( ( 1 ) <br /> DO NOT WRITE LOW IS LINE <br /> DTSC 8022A (4/971 <br /> EPA 8700-22 Green TRANSPORTER RETAINS <br />