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2018-02-01 10:51 Safeway 2707 2094728604 >> 2094683433 P 1/8 <br /> PIG, IVWe.(Form ded97red for use aneAle ll2-pitdl)typevrrg9r, � Fm APPAWe,t OW No.205(:-003E <br /> UNIFORM HAZAP=s 1•GaaaabrVD Numw 2.Paget of 3.Emergemy liespoma,PMne. twest rre Ing NUM)w <br /> WASTE MANIFEST CALOW289788 1 1�OD-4249300 0 afaWay ncl Vons ,�°Z J�K <br /> 'r S.Gena'abts Namaand MaaaMA>1Qre# <br /> Cwnealoys Slte Aeam;n rdddferen!alm,mai8ng edaasx: <br /> 5818 Stoneridge Mall Road Attn:Sharon Ploufe Safeway Fuel#2707 <br /> Pleasanton,CA 94588 6425 North Park Avenue <br /> GanrxeW*ftm! 626-821.-6192 Stockton.CA 95207 <br /> 6, mnapnrerlColrgary Nemo <br /> i.:fY11U,v::rtper <br /> Environmental Logistics,Inc. CAR000172450 <br /> 7.Taapear2cnmPam nme <br /> US.Ern ID Numtm <br /> 8. kd FadNyNeme end 9'deAddroaa r <br /> Hazmat, Inc. 01.EPAIG <br /> 6300 Stadium Drive,Kansas City,MO 64129 <br /> FaWtyaMn . 816-92¢5884 MOD981123391 <br /> 9a, 8b.US.DOT DesaipAon ihlGudug Frppasdpdng Nam:.Hued Gass,10 Norther• lox":NM 4xPacftGnxy8lanyj) 17e. Typn Quakh' :'APhA. 'AWw"'wfl <br /> o UN1993,Waste flammable liquid,nos(gasoline) D0010018 1343 <br /> x ` ' 34 PG if 1 DM , 25 P <br /> 3. <br /> 4, <br /> a. NnaaRn bawmpra arta n orlon mergency ReSQol7se w. E -8 >- "N- 823'd <br /> 9b1)Profile# AES432742 ERG#128 1 x 10 <br /> j <br /> Rejected from manifest#013481366JJK <br /> ts. GANERATORWOFFEROR'S CERTIFICATION:I nanebydadare 0101 Ne conhaa of*—bsrarum ere filly and XaR dewdhea sb+a by he propw wc*e nameaM a:s aaong .aarxaae,, <br /> maL+ed and IabaledlplaraCed,and ereN MraapaCla'n prapaeandihn Lx aanpertectorarNbeppkadeInumroom ad nabenY gavanurKK,N!reQela6erra ftexpat ah,emwneMlnm.Ihe Parkvv <br /> EamXar,I pertly Alai I)m cmkWSMNk crosigranenlmMmm b the tomLn oteA adached I:PAAcknAn?ad3maM M Va. <br /> I cAfy A!tltdb Wash MNu2tion s bonen ldendsd in 4e CFR 76227(al to l ama loge quan6tY geneabr)000141 em a^mac gamijII ralorj sa, jp <br /> GanaamfslOAaot6 PrtdaNiypq Name aignebre i !� `7 <br /> Steven Masters,offeror <br /> r1 s <br /> wparlta U.S. WErporthem U.S. ug ibs <br /> Pmt mU.S./ ................_.. ..' ....___.. _.. . <br /> � Trewyar6rapnefure(for exportsaRM; Dao lnavU.S. <br /> K 17.T lanspoftAdwmWirmall ofRwciddmmilds <br /> Tmn 1 ad core . . Sigra%areM r' Yaer <br /> `I T7 fs <br /> reneportw2 in dr<y(ad 8i0aauvd ntma, nq Year <br /> 18.01wspaircy <br /> 188.Daueoanc Indication Spare ❑ Ous my n❑ r�.Tpce tl Residue ❑Fe�wl Rafuno„ _�ruc Psje':ian <br /> Man4ut Ratem"Na r'. <br /> 161A.AhM98 FeGify(V Gemretarl U.S.EPA 41 e8Tmhet <br /> ua4 FanlWtPneft <br /> yaj 18c.Slgrebm of7mrnata GN VGrsrR/atpr) Y.om:: Ihy ftler <br /> !4 <br /> N78.XaaAda;Syhsle Repot Managamem Metlgd Codas(i.e.,fCdee lVhmrda4+84b ggpllal7,dledaHl,afltl faEyC6aD a)'4bms; <br /> 1. <br /> t0.0esigvtal FFalpy Oynar OpefaWf.CeT'kaCondroCalptdhsiiWua rlu!odal5 wvaad brBro nalAaNax mXgn lBa <br /> 1 me r^. �� AneAae 7 <br /> EPA Foml S7W-22(Rev.&051 Previou9 eddbns are obsolete. ESIGNATED FACILITY TO GENERATDF <br />