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Benz, <br /> °ene Approed OMB No.2050-0039(Ezpkm 9.3694) See Instructions ON back of ypepi S. <br /> 'ems pill or t .• Form designed f«we an eine(12pi")ype. D.pon noe of To..Sub.ranons CamW <br /> So .- ,Calif.. <br /> UNIFORM H4ZARDOUS 1' s Us EPA ID No. Moofesl D«"menM Na 2. Pogo I I darmatiim,n Me d,aded area, <br /> WASTE MANIFEST k rot reprinted by Fedmol I <br /> CR D. 981 4602 2 5 2 3 0 9 1 of 1 <br /> 1. Generator's Name rod Moing Address SHELL OIL COMPANY tManifealDdaimiNshANnden <br /> i HAZARDOUS WASTE DEPT. <br /> P.O. BOX 4848 nSs a e Den.Of. <br /> 4' Generat"rs Phone (714)520-3312 ANAHEIM CA 9c^8@3 <br /> 5. Tramp~1 Compmq Nome F'} t � '17 <br /> eft=c e sem, US EPA ID Nun batt c s at v.I avpo k/;{ID4 <br /> D$irmapwlers-. <br /> 7. Tran4 orler 2 Company Name SUS EPA ID hiarnher hs, rg„ <br /> E nTront�eds.IDa }fit <br /> F:oyTnarapate/s Pbarre++ <br /> 9. Designated Fca in <br /> Nome and Slta Address 10. US EPA ID Nlanfrer v t <br /> G sIM <br /> ERICY.SO"!t INC. <br /> 255 PARRBLVD. CAD 009466392 NOdvy's'PII <br /> 11. US DOT Dexription(«lading Proper Shipping Name,Hansard Oars,and ID Number) 12. Core"irmrs <br /> 11. Total ll Unit "F*M <br /> .:VIJ;'4—hLlHH !'lie a .. K ;J.� ..S:LiLr f Ne. T Nk/Vol vta'Wmte Nmn <br /> G <br /> Eb 00 ' P 0 8 0 0 0 P w.o <br /> E <br /> R <br /> A <br /> C r a <br /> R <br /> xOutlets <br /> d. <br /> Oiler <br /> Q.Adk&Worol.Wsoiptiota for A1ra.ribls 11dad Abow "S y r 1, s IC.. <br /> �AN}#�[5ANIkFIEEt�LASSJSTEEL� <br /> 15. SP«Ial Handling brOm ions and Addeonal Infamno on <br /> FACILITY- <br /> AVOID CONTACT WITH SKIN/EYES SERVICE STATION <br /> 24 HOUR EMERGENCY PHONE NUMBER (800) 424-9300 880 VICTOR ROAD <br /> U-1DI. C^. 95240 <br /> 16. G@IERAWR'S CERTIFICATION: I hereby d«Iare Mat Me contems of that condgnmem are full,and aoLL dmcribnd above Proper Pocked,marked,and labeled,and are in all rmpach in by P per dripping name and are classified, <br /> Proper condition for trnmpon by highway according le applicable federal,aae aril intonational lawn. <br /> If I am a loge quarmy gmeran'r, I certify Man I hove a program in place a red«a Me volume and O.klty of wave generated . Me degree I have determined to bs <br /> economically practicable and than I hove selected the practicable meMod of trey Dem. nonage,or disposal curren*available to me which minimize,Me prerem and furure <br /> threat to human health Oral the erwirormem;OR. if 1 om a smalla <br /> wase man 'mem 2"421 Mm is awiloblu a me and Man I cmr mfor� rotor. I have made a good faith teflon rat m.mmize �ny waste genenarion and select Me bent <br /> P' /Typed Name <br /> � )_tea-}�, ON EE::ALF vF Mamh Day r'ar <br /> Pte+ / SHELL_ O'L CO. (7 <br /> T 17. Trans 1 Ackrowkd emerrl of R«N of Maeriah <br /> e <br /> • PrimW/Typed Name <br /> Sigmnrre mcmh pay Year <br /> 18. bans ~2 A6ma led eme a of R«lei t of More riak <br /> Palmed/Typed Name N'naere Momh Day Year <br /> i <br /> 19. Dixrepanry Indication Space <br /> M. Facil' Owner or O eraror Cerfifko-of recei t of hazardous materials covered b Mis manifen e. as rated in Item 19. ` <br /> Primed/Typed Nome Signature Momh Day Year a <br /> 2044416080E+398c^ J6 DO NOT WRITE BELOW THIS UNE. <br /> Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 10 DAYS. <br /> 3022A D2/9t) <br /> Tam-22 To: P.O- B.. 400, Sacramento, CA 958120400 <br />