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4��P�� <br />f nia—Env+ronmentdl Protection Agency0Mf ,No. 2050 039 (Expires 9-30-99)� 1, See Instructions on back <br />i Please print or type. Form designed for use on elite (12 -pits ewriter. -r - <br />s <br />LCA <br />M n <br />C\j <br />� VJ <br />CD <br />C, <br />C <br />a <br />a <br />C, <br />ck <br />LL <br />t- <br />2 <br />IL- <br />LL <br />V. <br />2 <br />C <br />V. <br />LL <br />a <br />FL <br />tr: <br />cleC <br />} <br />Z <br />rY <br />LUO <br />V) <br />Q <br />V <br />FA <br />79e 6. Department of Toxic Substances Control <br />Ak <br />NIFORM HAZARDOUSPA ID No. Manifest Document No. 2 Page i Information in the shaded aneas' <br />=Generafor's <br />WASTE MANIFEST T {-: , _ is not required by Federal law. <br />2 2` 3—.5 all <br />3. Generator's Nome and Mailing Address . Staie)&In e3fD-cument Number <br />Q8 REBUILDERS <br />235 W.98592235 <br />CHARTER WAY STOCKTON, CA 9520 t neratoF s ID <br />- <br />A. Generators Phone 1209 ) 467-0490 --T' `- <br />5. Transporter 1 Company Name ., b. US EPA ID Number' =-. <br />.C, State Transp tier's ID <br />t <br />-D.-Transporter's <br />II 'ti Al /` C T A� <br />Phone <br />_ <br />7. Transporter 2 Company Name 8. 'UrEPX ID T4.Aer <br />595, 599i <br />E. State Transporter's <br />�T�Uh 14 C 11-1 L 7�1 i0g�� <br />F. Transporter's Phone <br />J <br />9. Designated Facil ty Name and Site AddressS <br />10. US EPA ID Number <br />G. State facility's ID <br />DEMENijtc--KERDOON <br />J J u <br />2000 N. ALAMEDA STREET <br />H. Facilitys Phone <br />CA <br />11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) <br />12, Containers <br />13. Total <br />14. Unit <br />No. <br />Type <br />Quantity <br />WtN I <br />L Waste Number <br />a. <br />NON RCRA HAZARDOUS WASTE LIQUID <br />'State .' <br />G <br />E <br />(OILY WASTE WATER),EPA-/Other <br />L <br />M <br />Q0 <br />EPA/Other <br />b <br />N <br />state t <br />E <br />R <br />EPA/Other <br />Aa <br />1 1 1 <br />IFIEDT <br />O <br />CSftliO <br />FOR P,ECYCLING/Tt EAT ,ENT AT T"HE <br />R <br />! <br />DeMEI4NO/KERDOON FACILITY IN COMPTON, <br />EPA/other <br />d.1 THIS FA I h <br />PERMITS TO RECEIVE YOUR WASTE STREAM AS <br />State .` <br />EPA/Other <br />� CAT080013352. <br />J. Adds cnp ;ns or Materials Listed Above <br />K Handling Codes for Wastes Listed Above <br />^ <br />C: <br />d. <br />15 Special Handling Instructions and Additional Information `—,) <br />c/3 O <br />APPROPRIATE CLOTHING " r <br />24 HOI.yR EMERGENCY RESPONSE - CHEM TEL, INC:" �-800-255-3924 <br />16: -GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, <br />marked, and labeled, and are in all respects in for highway <br />proper condition transport by according to applicable international and notional government regulations. <br />If l am a large quantity generator, 1 certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br />practicable and that I have selected the method of treatment, disposal <br />practicable storage, or currently available to me which minimizes the present and future threat to human health <br />and the environment; OR, if I am a small quantity generator, I have mode a good Faith effort t minimize my waste and select the best waste <br />generation management method that is <br />available to me and that I can afford. <br />P inted/Typed Name Signature- Month Day Year <br />b �' i't2G / D Z r <br />r. D <br />T <br />R <br />17. Transporter 1 Acknowe ement of Recei t of Materials <br />NP <br />'nted/ ped Nome w w <br />S' re <br />Day Year <br />S <br />P <br />//(Ja <br />_ <br />/MMont�hy <br />Oil <br />D <br />R <br />18. Transporter 2 Acknowled emenl f ecei t o Materials <br />T <br />P Print T ed Name _ <br />/ <br />f y�r <br />Signatui 1 f <br />Month Day Year <br />19- Discrepancy Indication Space <br />F <br />A <br />C <br />I <br />L <br />1 <br />20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19 <br />T <br />Y <br />Pri nLed4 <br />Typed Name <br />r <br />Signa — <br />9 <br />Year <br />Month D�y`7 <br />c <br />lz. <br />I1J <br />D(�1J(]t_WAIT,r/EiLIAIA!_TL1IC_IIAIF_ <br />w �� <br />