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mia--Environmental Protection Agency <br /> .ed OMB No 2050-00J9(Expires 9 30.94) See Instructions on back of Page 6 Department of Toxic Substances Control <br /> d jo type Form designed for use on elde(12-prtch)fypewrster Sacramento COlifomio <br /> UNIFORM HAZARDOUS I Generators US EPA ID No Manifest Document No 2 Page 1 Information in the shaded areas <br /> i <br /> WASTE MANIFEST CAL 10 10 10 19 14 $ 15 L2J 8j U 13 14 4 17 1 of 1 s not required by Federal low <br /> 3 Generator s Nome and Mailing Address t I <br /> CANTEEN CORP. <br /> N 1500 SHAW ROAD STOCKTON, CA. 95205 <br /> in 4 Generator's Phone <br /> W (24g1 847 8757 <br /> 0 5 Transporter 1 Company Name B US EPA ID Number <br /> M <br /> n <br /> 7 Transporter 2 Company Nome 8 US EPA ID Number <br /> a <br /> V <br /> 0 <br /> Z 9 Designated Facility Name and Site Address 10 US EPA ID Number i 1 <br /> 0 <br /> O PETROLEIJL RECYCLING CORP, t , <br /> 1835 EAST 29TH STREET <br /> 4T71 , CA. 908A6 <br /> V <br /> 11 US DOT Description(includmg Proper Shipping Nome Hazard Class and ID Number) 12 Containers 3 ata 14 Unit <br /> Z No -Type Quanta Wt/Vol m <br /> ti o <br /> NON RCRA HAZARDOUS WASTE SOI,,ID <br /> G (SOIL, TRACE GAS) <br /> E U M G <br /> lV <br /> coo N b r <br /> C0 <br /> a E <br /> N R <br /> v A <br /> 0 <br /> o T c <br /> cc <br /> — 0 qz <br /> cit R <br /> w <br /> Z d t <br /> W <br /> V <br /> u.r <br /> I n <br /> V) <br /> LU <br /> Q <br /> Z s <br /> O 15 Speual Handling Instructions and Additional Information <br /> Z 24 HR. EMERGENCY CONTACT. 800-ty4--4444 <br /> 24 HR. EMERGENCY RESPONSE. CHEM TLL INC. 800-Z55- 1924 <br /> APPROPRIATE PROTECTIVE CLOT �ING & RESPIRATOR <br /> J 16 GENERATOR S CERTIFICATION I hereby deIpr ha <br /> tt the contents of the consignment are fully and accurately described above by proper shipping name and are classified <br /> Q packed marked and labeled and are in all re�ects in proper condition for transport by highway occording to applicable federal state and international lows <br /> V <br /> If I am a large quantity generator I certify that I hove a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br /> 1 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 /> 4' <br /> in threat to human health and the environment OR if I am o small quantity generator I have made a good faith effort io minimize my waste generation and select the best <br /> CLI waste management method that is available to me and that I can afford <br /> Q Printed/Typed Nome Signature Month Day Year <br /> U <br /> Z T 17 Trans Tier I Acknowed ement of Receipt of Materials <br /> � R <br /> Ur N lm��Aw <br /> Sign Mnth Day ar <br /> 5 Ito <br /> LUp 1 B Trans orter 2 ed ement of Rete. t of Materials <br /> tiPrinted/Typed Name Signature Month Day Year <br /> O A <br /> uj 19 Discrepancy Indication Space <br /> V) <br /> Q F <br /> V A <br /> ZI <br /> — s <br /> L <br /> 20 FacilityOwner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19 <br /> Printed/Typed Name Signature Month Day Year <br /> DO NOT WRITE BELOW THIS LINE y <br /> pTSC 8022A (7/92) <br /> EEE 4k1f L1.J V, f ✓i ,s3 JlI <br /> EPA 8700-22 <br /> Yellow GENERATOR RETAINS <br />