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<br />onmensnl F,o+ect.on Arpnry
<br />,rna No, 20 -0 -DOSS jE its"., 9.90,941 S"f nStruCtiAns on back Of ptyge 6. p•poi, enr at Te■k Subnc++ed Conrrel
<br />ee type. Form d,r,yn.d for uss on elee 112-pikh) rypeW 5acro.nen+o, CaliSarno _
<br />k ' ManifeSt Documtnt Na.2. Pae 1 In4er,nahon in the shaded omt% I
<br />1. W. )rs US EPA Oto 0
<br />' UNIFORM HAZARDOUS
<br />i, nor requ,r.d by Federal low,
<br />WASTE MANIFEST I I i j I5�1 i a{
<br />1 3. Generator's Name and Mailing Address -
<br />t. Generator's Phone'
<br />I
<br />5. Thmmorler 1 Compony Name b. US EFA ID Number
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<br />ENEN TROPU 4dEST 1 •1 Ai OI Ri Oi 0!
<br />i 7. Transporter 2 Company Name G. US EPA ID Number
<br />9. Destanotod Facility Nameand Site A04r 10. US EPA 19Number
<br />i 13331 N. UWY . 33
<br />PQTTERSON, CA. 95363 I C1 A! D! Oi SI 311.1
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<br />11. U$ DOT Description Cncludmg Proper Shipping Name, Hazard Clui,, and ID Number)
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<br />G I NON RCRA HAZARDOUS WASTE LIQUID
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<br />12, Corrwntm 1 13. Tota' I 14. Unit
<br />�h1a. 7vpe I Ouontity - I WI/Vol
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<br />• .State �• .
<br />I I 'EPAJCkYter • '
<br />!3. ,Addt:onol i�esvipfiet,s T?r.lAntrYinfs. f fd,4ff A}toYC•y - _ -- - :;a.� . ._. {andling Codec 3or WG los (;led Abava
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<br />WATER & O7L -
<br />1 15. Speciol Hondliho_ Instructions and Additional inforn,otian
<br />24 HR. EMERGENCY CONTACT: FRC
<br />24 HR. EMERGENCY RESPONSE: CHEM TEL INC. � 1—(E?GG i-235-3924 t
<br />APPROPRIATE PROTECTIVE CLOTBING E PESPIRkTOR.
<br />.
<br />I e GENERATOR'S CERTIFICATION: I Waby declare fhot the contents of , cons,pnm5nt are Ivliy Ond o:curate y oesU,bFa above by proper shipping name and ore ugtsfited,
<br />packed, marked, and labeled, and ate, in all respects to proper condabon for tronsprm by highwOr occoramg to applicobia federal, state and international low&.
<br />II I om o forge quantity generator. 1 certify that I hov¢ a prograr, tr place to reduce the v7ve,e and tax•city C1 waste generated so the oeQr¢o I have detOrmined to b!
<br />economicpliy pract.coble and that I hove talecred the prachcobie meti,od of treMment, starOg for drovsOi Surrently ovaiieible to me which rn.nimtzes Hte Present and fuwrF
<br />threat to hv.non health and the ehvirohmant; OR, if I O•A a small auontity oenetator a de o good toith a to , �.nlmae my waStF generation and select the bag'
<br />wash monogement method that is avoilobla to me and that I can afford.
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<br />I Print¢d/Typed Nome f .rilanaNr!
<br />t i Ti. Transportet 1 Acknowleooemant of Receipt of Mptarioh
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<br />e lE iia sponer 2 Acknowledgement of Receipt of Male,iOlS
<br />TPrinted /Typed Nome ! Sianoh.re Month boy 'Yea,
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<br />I ;Stale•- .
<br />I !.State' _�'•"'` � '
<br />1C, D.,arepancy Indication SOOCe
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<br />i 2C^ Focil.ty Owne- or Oaerotor I
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<br />yDO NOWHITE BES
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<br />/Mon+n Go, Yee'
<br />THIS LINE. '
<br />r.nt, TSY S' -.N. -I; THtk COON' TO DTSC Y;;iH N = _/
<br />Secromentc, C. 45f•'•=
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