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.r—Environmental Protection Agency <br /> OMB No,2050-0039{Expires 9 30-941 See Instructions on back of page 6 Deportment of Toxic Substances Control <br /> 7type Form des+gned for use on elite(17-perch)type-roar Sacramento California <br /> 1 Generator s US EPA ID No Manifest Document No 2 Page 1 Information to the shaded areas <br /> UNIFORM HAZARDOUS is not required by Federal law <br /> WASTE MANIFEST of <br /> 3 Generator's Name and Moiling Address e D <br /> CANTEEN CORPORATION <br /> 1500 SHAW ROAD, STOCKTON CA 95205 <br /> 4 Generator s Phone ( ) $ <br /> i1n847 8757 <br /> O 5 Transporter 1 Company Name 6 US EPA ID Number <br /> O <br /> CIO <br /> PETROLEUM RECYCLING CORP. 14TIOP101110W <br /> r 7 Transporter 2 Company Name 8 US EPA ID Number <br /> V <br /> Z9 Designated Facility Name and Site Address 10 US EPA ID Number <br /> +� 0 PETROLEUM RECYCLING CORP. <br /> T? �L- 13331 NORTH HIGHWAY 33 <br /> —1 a <br /> Y) V 12 Containers 13 Tocol 14 Unit <br /> Z 11 US DOT Oescrrpbon(including Proper Shipping Nome Hazard Class and ID Number) No Type Quantity Wt/Vol e <br /> 3 G <br /> 1 t " I <br /> coo N b HYll OCARBUNS l 1¢ <br /> ca E <br /> N R <br /> v A <br /> 0 <br /> o T <br /> co O <br /> Ce R <br /> w <br /> s— d <br /> z <br /> LU 4 �{ <br /> U <br /> d or w <br /> a 1 <br /> V) <br /> LU <br /> Q <br /> Z <br /> 0 15 Special Hondlttsg Instructions and Additional Information <br /> a 24 HR. EMERGENCY CONTACT: 1-800-874-4444 <br /> Z <br /> LU 24 HR. EHERGENCY RESPONSE: CHEM TEL INC. 1--800--255-3924 <br /> = r <br /> & RESPIRATOR <br /> 16 GENERATOR S CERTIFICATION I hereby declare that the contents of the consignment ore fully and occurolely described above by proper shipping name and are classified <br /> a <br /> packed marked and labeled and are in all respects in proper condition for transport by highway according to applicable lederol scale and international laws <br /> V <br /> H L am a targe quantity generator I certify that I have o program m place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br /> economically practicable and that I have selected the practicable method of treatment storage or disposal currently available to me which minimizes the present and future <br /> Qthreat to human health and the environment OR if I am a small quantity generator I have made a good faith effort to minimize my wosse generation and select the best <br /> N <br /> waste management method That is available to me and that l con afford <br /> W <br /> 0 Printed/Typed Name Stgnosvi, Mont ay ear <br /> J <br /> 14 <br /> Z .� f <br /> V r an <br /> 17 Trs orter 1 Acknowled ement o acei t of Materials f <br /> � <br /> N Typed Name St�r ptur Month Day Year <br /> s 1 / 7 <br /> W p <br /> 0 18 1,6r14'r"IAcknowled ement of Rete. t o asenals <br /> W RPName Sr nal re Month Day Year <br /> LL- <br /> 0 <br /> LO a <br /> w 19 Discrepancy Indication Space <br /> Q F <br /> V A <br /> Z C <br /> I <br /> L <br /> I 20 Facilft Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19 <br /> T printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE <br /> DTSC 8022A (7/92) �V11aiS.._.. v + <br /> EPA 8700-22 Yellow GENERATOR RETAINS <br />