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Mo.2050--0039(EnpkesW3"1) and Front of rags f Secraemersto,L;Arnorwe <br /> Form ApfDwd for sae on*No(12*Odr fryer.404. <br /> ORM HAZARDOUS 1 —,We US EPA ID No. cw"oftat Page 1 IIANMn"tion In ifrs shaded arose <br /> WASTE MANIFEST ` o o b 5 b D O 6101 p wo' at 1s ad required by Fw$"low. <br /> tors Nems and 1ltailing Ad"" � QMH 6Q.AnJru A. &tate maeom <br /> lob i i Oil site Tr�rt� f :'- " l 3753 <br /> 836 B. South HamptOA Rd. #300 Benicia, CA 94510-1907 a. B11aa,a,ra„�aID <br /> s. Generators Phew.c 707) 745-6160 '4 t 0�6 <br /> !ti Transporter 1 Convowt'Name fi US EPA D Number Q 39doTramporteh� <br />/ O;Ttwsportere <br /> 1 0 7. Transporter 2 Camparw N-W fl US EPA ID Number F Sudo Trawspo ws D <br /> F. raweparwo Phsae <br /> g. ps,ipmaled Facility Na—and Site Address 10. US EPA Q Number Q $tato Focus ID <br /> Gibson Oil / Pilot Petroleum KFr� oPhoaa <br /> v 475 Sea Port Blvd. <br /> X 12. Contakwo 13.TOW L <br /> pName.Hazard Class.and ID Number) No. Type Unit base No. <br /> 0 11. us DoT Dssuiption ptrelrrdieq Proper Shipping <br /> LL <br /> RQ Hazardous Waste Liquids NOS ORM E ataa223 <br />.Z IPA)QIhw <br /> G ! f.'. <br /> N NA918 ansa , <br /> )3 E b, ;. <br /> EPPJONW <br /> T <br /> 4 '0 rinds <br /> Of <br /> R a. sc_-IL <br /> 3taMe ' <br /> y�r Il�ruothar <br /> V p..�t�e�..far MatarlaM Listed Above �, fC Hand bg for waste&Listed Above <br /> �' y rocarpon !fixture With Water ti� -� � ' <br /> i' <br /> ( 99x Nater, 1% Hydrocarbons) s4 <br /> s ,�{,- !•` .`'" ?t ,,..�- syr L <br /> Cox <br /> 16: NandingMrsLrrctYoms and Addtlbnai Mormaliorl <br /> son Oil Waste Stream Profile # ERG 31 � <br /> Z 4 24 Hr-' hone' 41S b8L [�Z• �t-o4-� �3s7'°4f3 I <br /> J <br /> 4 1a <br /> GENEw►Tott'S CIERMICATIOtt 11►orebY codon that the oonlorda d Ihi"oomignneat ora HiIY and aeerraeofy a.ocrtb.e abora to bl.Nt <br /> J and am cis& d.packed.ma*od.and labeled.and am b al respects Is proper oorWion for transport dYrp <br /> by Wm*Y aeeor <br /> J national government mguialkwo. <br /> ¢ ■1 am•carpe tpsMltY Lia-orator.I e rflfy that t haw a program N place to tedwo the voles w and toxicity Of wsato generated to tha dag►ee 1 Mw dstemrinod <br /> O to be scononrkaly proclitable and that 1 have soiected the practicable method of tre&tmoM.storage.or disposal arrreM d faith M to me Wric)r miry wast ler <br /> pro and%*we Liras,10 hwnan health and the eavirorunat OR,N 1 on a small gwntthr generator.1 have made a good faith Nloft t0 minirrao ray wash <br /> V owwwation sod"Nett the best waste msnagemeM rMtlwd that b evaiabla to race and that t can afford <br /> true A0000 par Yaw <br /> µZi Prlrrt.a/7Ypod Narwa ��/� <br /> s�t yG /Dia p� <br /> Al 04d I0i1� o�iyn /�L,) <br /> ya 17.Transporter t AcknowfadgameM of liacaipt of ldabri w Month par Yaw <br /> fffZ��� Nas Sipnat O J <br /> Nttl. T er 2 Ackr4 wtedgamart d Receipt Of lertala Arawtlr Year <br /> T nH <br /> PridiTyped Name 8fpwtrr� <br /> tE <br /> Z – <br /> �Y. Diaerepaney inatatiow Space <br /> IF <br /> A <br /> G ' <br /> 1 <br /> 1 20. Faclity owner or Operator Cartlfioatioe of reoelpt of hazardous materials oovered by this manifest except ad 10. Asodfl M Year <br /> T PrYrt"d/Typed Nana 310eature <br /> DHII GM A ' Do Not Write Below This line <br /> GPA 4700-42 <br /> "Ulm.• Previous ad111oas am ebsot"ta WNW TW SEMM TMS OOPY TO DOHS W ff M 30 DAYS <br /> •• <br /> To.. R.O.goat 3M,Sw=rwb,G M12 <br />