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1__� <br /> NON-HAZARDOUS 1.Generator ID Number 72 %ge 1 of 3.Emergency Response Phone 4.Waste Tracking Number <br /> WASTE MANIFEST CAL000218409 909-721-2038 NH141384-N <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> STOCKTON SAILING CLUB INC <br /> 4980 BUCKLEY COVE WAY <br /> STOCKTON,CA 95219 <br /> Generator's Phone: 209-951-5600 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> ENVIRONMENTAL LOGISTICS, INC CAR000217513 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> 8.Dpsliprla}ari F*kfvsV %Site Ad VECES, INC. U.S.EPA ID Number <br /> 180 WEST MONTE AVENUE CAD982444481 <br /> RIALTO,CA 92316 USA <br /> Facili 's Phone: 800-698-4377 <br /> 9.Waste Shipping Name and Description <br /> 10.Containers 11.Total 12.Unit <br /> No. Type Quantity Wt.Nol. <br /> 1 <br /> NONHAZARDOUS WASTE SOLID(OIL FILTERS) DM P <br /> a <br /> cbb <br /> W <br /> Z 2 <br /> W <br /> 3. <br /> 4. <br /> 13. Special Handling Instructions and Additional Information <br /> 9B1)OIL FILTERS# WEAR APPROPRIATE PPE INV#141384-N <br /> 14. NERATOR'S CE TIF ATIO :I certi th materials described above on this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste. <br /> Gene tor's/Offe or's P me pe Name SXre ((� ! Month Day Year <br /> 15.Interna onal SlifpmentsEl <br /> I— Import to U.S. ❑Export from U.S. Port of entry/exit: <br /> Transporter Si nature for exports only): Date leaving U. : <br /> cc 16.Transporter Acknowledgment of Refeipt of Materials <br /> W <br /> 2 <br /> Tra sporter 1 PrinI d/Ty Name Signatur Month Day Year <br /> O <br /> CL �(J <br /> 0 <br /> Z Transporter 2 P' d/Typed Name Signature Month Day Year <br /> cccc <br /> H <br /> 17.Discrepancy <br /> 17a.Discrepancy Indication Space F .TER RECYCLINGURVICES' RI&T4f AC:ILI ,CA rtial Rejection ❑Full Rejection <br /> # w44wi HAS THE APPROPRIATE PERMIT(S) FOA,, <br /> if f <br /> 17b.Alternate Facility(or Generator) ANu VOLL U.S.EPA ID Number <br /> V <br /> I Facility's Phone: <br /> w 17c.Signature of Alternate Facility(or Generator) Month Day Year <br /> a <br /> Z <br /> C7 <br /> N <br /> Lu <br /> O <br /> 18.Designated Facility Owner or Operator:C rtification of receipt of materials covered by the manifest except as noted in Item 17a <br /> Printed/Typed Name Signature Month Day Year <br /> d / <br /> 169-BLC-0 5 11977(Rev.8/06) DESIGNATED FACILITY TO GENERATOR <br />