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11,'01/1994 09: 39 415 325-3808 ANTIFREEZE ENVIcVC C PAGE 02 <br /> Poe 20-50-OW?(Ex � ) St, Instructions on back o 30 . o.Pa.xn«+f of Tp.rk SubMa�c..C❑rr.r <br /> Sovam«,w,casfw— <br /> �,p,..r a ripe• Yvrnwirye.4.rlA use on• (1! J yls•wrM•►. <br /> 1. G *ewatoes US EPA 10 No. MaNfoo Daraf>Mfd -1{ Z. Pao• 1 Inlormation in M•shaded oreae <br /> FSANBORN <br /> ORM HAZARDOUS - rout required by F•d..d kw. <br /> ASTE MANIFEST of 1 <br /> r't Name and"ling Addnm , <br /> C IA ID 10 <br /> ,.I' Ro'q - } P I <br /> CHEVROLET <br /> 12LO SOUTH CHEROKEE LANE LODI , CA 95240 <br /> A. •roto <br /> )t Pts ho ( I 1114-50110 <br /> S. Tro—poAef I Company Name 6. US EPA ID Number r s <br /> ANTIFREEZE ENVIRONMENTAL SRVC. ICAD 1918 11 161914161614 . <br /> f <br /> 7, transporter 2 Company Nome 8. US EPA IO Number <br /> ( � Q <br /> J <br /> 9. Ciwugnofed Foc,lity Name and Site Address 10. US EPA ID Numi>.r ` <br /> L ROMIC ENVIRONMENTAL TECHNOLOGIES ' <br /> 2081 BAY ROAD <br /> L EAST PALO ALTO, CA 9 03 CAD 0 0 9 4 5 <br /> Q12 conroim•n 1�. Total 14. Unµ <br /> J <br /> 11. US DOT D*K111560n(Including Proper Shl piny Name,Hoard Class,end ID Numbers No T C�uartMv Wt Vol <br /> = a' ETHYLENE GLYCOL S LUTION (<50%) <br /> p NON-RCRA HAZARDO S WASTE, LIQUID 0 0 1 T IT G <br /> N b. <br /> t <br /> n R a <br /> A <br /> T C. <br /> op( 0 a <br /> R <br /> �oyc� c <br /> t d. g I <br /> V) y <br /> k�a <br /> U) t, <br /> a' h <br /> J <br /> Q <br /> 15. Special Hmdling Indrutflom and Add nal Infer <br /> GLOVES AND PROTECTIVE CLOTHING EMERGENCY RESPONSE PHONE # 41513241838 <br /> LU ROMIC PROFILE #201 i 1 <br /> = r shl te name and❑r+ckywfied, <br /> ib. flF_f:rRaTCR'S C&4T:,q!'AT10Nr I hereby declareµsat tie contwm of this cornpnrreM ore fully and accurately detcr�d atamofiorsol�matlarsul povwnmeat regulations. <br /> pocked,marked,and labeled.and are in oil rnpects n props condition for tror"gore by highway ocmrdlrq to❑pp. <br /> d <br /> Vsm 1 how deeermned to be <br /> If I am a large quantity gperaror, I certify that I how a program in pix• to r+drxe Me .IuQ•disposal <br /> °� currently a.allob ro the whienerated to ch m n mrs•s Me pre+•^e and fvt-6 <br /> Konomkolly pfocticabl•and Mot I haw s•bcted tie prookabl•method of <br /> &M, storage,have good <br /> °�faith effort ro min{mlu my woo 1; <br /> 9e"'r°ti°^ o"d uled M+e b"sr <br /> 4 Mr•af ro human Mahh and M• •mAronmontr OR, 4 1 am a %mail,quor" pe^e Q <br /> N wash►mo meMod+of is available to m•and that I can o4lord. Month Day Year <br /> Prir>ted/Ty4d.Norn^ Sig • C <br /> 17. TramJ`omr l Ack I•d mm eof R•cM�`of Moterials month Day Ywr <br /> tZ{J sla <br /> Printed/T •d Name <br /> s o 18 T ornr 2 kno of R o+ oM Mo^r1 Day Year <br /> u7 " PrMNd/Typed Name n <br /> r <br /> e <br /> LU 10. D1scr+pancy ndlcat{on$pow <br /> A <br /> Z <br /> C' <br /> manif • noted In Item 10. Year <br /> 1 0 F II r or ratty nlQlkarNon ravel 071 rdous m als tow Ma,µ, Day <br /> T Prlr>t•d/Typal t'Jor'w �/VG r�A 1/ SlGnolur. <br /> r � MI PORTERS <br /> DO NOT WRITE BELOW THIS UNE. <br />