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n1i1-/^nn.^ 1^ 0z FAX 559 386 6109 KHF SITE SERVICE 002/002 <br /> r !.fn• n Enw;ro r^ -dl Prole t on Agency See instructions on back of pa - Dopartment of To.ic Sub,Ianca:Control <br /> .r QQ+i(°xp.res 9-JO.99J - - Savomenlo_California <br /> �F rte on n e. N6 No t <br /> term n d% 2-oite <br /> ed elite!t hl ypavrrler. <br /> ManileM1l Documcnl Na, 2. Pogo 1 sFormanon the shooed occas <br /> . Ganerotor's US EPA ID No. i,not regvlrad by Federol low. <br /> ' UNIFORM HAZARDOUS 0 of 1 <br /> WASTE MANIFEST C A D 0 7 9 6 9 2 9 01 ]L <br /> A. Stare Man4fesl Documcnl Number (/��1I (T''1(�/ 1 '�'1 <br /> ^_rator•5 Name onJ Ntallin9 Address L 1 V 1 1 V o 3 <br /> INTEP.LAKE MAT ERWL fiANDI}NG INC B. Slot,Generator-ID <br /> n r 1024 5.SACRAMENTO STREET CA 95240 I <br /> NODI <br /> ur) enera!a/s phone ( C. Stole ran, <br /> ID IRrervad.] <br /> r. 6. US EPA ID Num- <br /> C:4 1 =. Trampertcr{Company Name <br /> v.. D- Tronsporlor•;Phone PP427-72n <br /> 6 1 1 EM/IRONMENTAL RECOVERY'SERV- LCAd 0 d l 9 ? 3 9 E. Stole Tronspatleis ID(Rr-erveel,] <br /> O 8. US EPA ID Number <br /> r� - .;- s Cor-Cony Nome <br /> Transporler':Phone <br /> t <br /> ! G. State Fac;it 's ID <br /> 10. US EPA ID Number <br /> CVJr_m( J'l WASTE MANAGEMENT I.I. fee,iy,Phone <br /> 31 OLDSKYLINE RD. (53)386-9711 <br /> _KET C CA 93239 g O o 0 6 6 1 1 7 <br /> ` 12, Camomcrs 13. Talo1 14. Unit <br /> i l'S DOT Descr;pticn(:nc!cdiny <br /> me,Propel Sk;PP;ng No <br /> Nazord Clore,and ID Number) I, T pe OunhtY WI/Val I. Waste Nuntbcr <br /> Stplq <br /> .�hV <br /> NON RCRA F{AZARDbUS WASTE,LIQUID(TANK SLUDGE T T EA//Olcr <br /> r <br /> 3 i I O O Q sloe <br /> E ; <br /> tI EPA/Other <br /> L <br /> cl' R Slak <br /> cwt', � <br /> EPA/Other <br /> Slate <br /> i <br /> EPA/01h-, <br /> K. Noodling Codes for Wastes Uslod Above <br /> lddiGcno',Dccr;ption:la•Maicria!e Liaed Above b. <br /> NAEPG# 11A NONE <br /> 1iA)Ev3i593-TANK SLUDGE <br /> I , <br /> .:•1 -r="-• .�..,'^rs cad Addicv^c'In minion <br /> r'_P.LL 94ARO SERV 567-427-7277 <br /> is rILI_TC'EMPRONMENTAL COVERY SEP.VICES USE PROPER SAFETY EQUIPMENT ERS W.O.dIC3484 'Ht's' <br /> �•;S I shi n no and are classilird,packed, <br /> �t rC r r'FF11FI�nT!O - hernov sac taro+hc ^ ccn'^n�,of this cons;gnmen! <br /> 1o•c Fully and accvwtd doscr;bcd abase by Proper PPi 8 nor <br /> in proper mnd'fien for Iransporlby higbv.ny according ro appticeble{nterratronal end nollonal government regulations. <br /> .,rge euanlly ganerawr, car!ify b.a�.l ha•o a program;n place to reduco the-olume and toxicity of vette gcnormed Io the dogree t hose ddermined to be economiiure Ikew to Ilium— e 11 <br /> pracrtca4le and rho'! ave selected the TracGcabla enaratoo lhha•e model o goo afo; effort torm^tlm Ee1my lc to me v+a e g cr1atiunrand ncleclIke <br /> 4'.bell adze management method ho`in <br /> 1 .n..+.�.4r.cr^;ro^mnnt:OR. If 1 am o sora quan cry 8 <br /> n available'n me and that co„afford. <br /> //m••��orth Day /Y�Cor <br /> � Sign ur •Y L'- lJ � � �I V <br /> I .m•c1 YS ei Na ��� <br /> J'1,\ <br /> -' !l G' <br /> 1 Ackee•vtad anent of III r of Man r;ol. <br /> „t Month Day Year <br /> r�i a er;nm2/Typed Nom. Signal ® ^ 2 <br /> (.� <br /> i t a. irons^error 2 Acin curled emenr of Ceeei !of Mvteriols Month Day Year <br /> > vrintod/TYCed Name $19no oro <br /> w 1 <br /> So— <br /> L <br /> er O ervor rvolicallan of recciol of hazardous mvteriah co+ered h I monift,t etas t os noted in llem 19. Month Day Yeo, <br /> $ignaturP /� <br /> ` DO NOT WRITE BELOW THIS LINE. <br /> -: - 559 386 6109 PAGE.02 <br />