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FROM (MON)JUL 9 2012 16:34/ST. 16:32ZH-. 75ISGS4107 R 6 <br /> NON-HAZARDOUS 1.Generator 0 Number 2.Page 1 01 3.Emergemy Respor Phone 4.Welts Tmddng Number <br /> WASTE MANIFEST CAL000218409 1 909-721-2038 NH141384 N <br /> 5.Generators Name and Mailirq Address Generator s SYe Address(Y Newt tl an me3irrg address) <br /> STOCKTON SAILING CLUB INC <br /> 4980 BUCKLEY COVE WAY <br /> STOCKTON,CA 95219 <br /> Generators Phone: 209-951-5800 <br /> 6,Transporter 1 Company Name U.S.EPA ID Number <br /> ENVIRONMENTAL LOGISTICS, INC CAROW217513 <br /> 7.Transponer2 Company Name <br /> U.S.EPA ID Number <br /> 6.DMtf9VV961&%ft10ES.INC. U.S.EPA ID Number <br /> 180 WEST MONTE AVENUE CArxaa24444.21 <br /> RIALTO,CA 92316 USA <br /> jFxHii Phone: 800.698.4377 <br /> Waste Shipping Name and Descroon 10-Containers 11.Total 12.UDO <br /> No. Type y Wtivol. <br /> NON HAZARDOUS WASTE SOLID(OIL FILTERS) plyl p <br /> 2. <br /> {Jr <br /> 3.. 3. <br /> b <br /> a: 4. <br /> � n <br /> 13. Special Handling Ins6uckm and AddtlonalIrdonnation <br /> 981)OIL FILTERS# WEAR APPROPRIATE PPE INV#141384-N <br /> 14, NERATOR'S CE A :I c0rllffyTatefials descdbed above on ft manil are not subject to federal regulations for reporting proper disposal of Hazardous Waste. <br /> Gene toes" rs P S' re t Month Day Year <br /> Ws k <br /> -A, 15.Interna is ❑ <br /> F Import to U.S. ❑E*m from U.S. Port of"Hart <br /> Z <br /> Transporter Signatre for exports only): Date leaving U. <br /> w 16.Transporter Adagwledgment of ReFeipi of Materials <br /> T spo0 1 Printed/Tyj ame I Signs% Month Day Year <br /> O 0 <br /> a <br /> w <br /> < Transporter 2 PNw&k7ypGd Nara Signature Mordh Day Year <br /> F- <br /> 17.DisereparRy <br /> 7a.Discrepancy Indicatcn Spa aFkRECYCLIN r <br /> 11MES' RI ,�tiG1U , ru Rejedion ❑Full Rejection <br /> #CADW444481 HAS THE APPROPRIATE PERMIT(S) FO , <br /> .7b.Aft e nate Facility(or Generator) U.S,THIS WASWOMMOPM <br /> EPA ID Number <br /> 1 <br /> V <br /> la1 Facilgs Phone: <br /> Lou —17c.S+gnature of Alternate Facility(or Generator) Month Day Year <br /> Q <br /> Z <br /> C7 ». <br /> 16.Designated Fadl'dy(tomer of Operator.Cifficaon of receipt of materiels covered by the manbst except as glad In ham 17a <br /> PontEdiyped Name Slgnahue Month Day Year I f 61!T— -- i <br /> Cit 0 1 <br /> 169-BLC-0 5 11977(Rev.8106) DESIGNATED FACILITY TO GENERATOR <br />