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•t„'-at�;�,�•,r.,.� �;, ` r �. '^4 > ,hiPnif3rit Dam: <br /> Driver Signature(Prints ' <br /> C <br /> �xr sista,alp . �'• ' � <br /> 1 <br /> Site'Phpne: e Truck# <br /> .. . <br /> Product <br /> waste <br /> Cod;iCPA Writs Gfqukt(tiled 0a CA Manliest r1O Qua I' <br /> .lobr►fating 221 ” unite price Arnourrt f <br /> No dRA <br /> Hazerdoe8 W <br /> RCRA Ha aste+tigeia(tiled.04):'Indu <br /> watis Wa ' <br /> iVon-RCRA s Lgitid Nsed Aufomotrve A } 134 Gat j a" <br /> Nazarfious Waste (Od&L' id 1 <br /> � Wa <br /> Nan-RCRA Naaatzw Waste SONS Conmm 221 <br /> Used Oil 223 Gar f ` <br /> Otabted <br /> OR Fft 0111,14s) •' <br /> Fm*Murgs) <br /> 0 on"*) i <br /> 7+ansa rwim ft trick Time 2 16 <br /> Each #. <br /> Hazardous.Test <br /> HRTAN <br /> aftwn <br /> gAFApT <br /> i <br /> be <br /> fed a,trds c°"sorradmantftw ttcei Teeter A <br /> a ;CtrARGE at ffta PER Oj tL17E of 9-1' °ma,wws,y��orf thee.lowgl sof Ria /���.��� <br /> C r '•t••"tttl.whichraftANNUALP .`...'•".t�.nihorpurtdraae. <br /> �RCENTAC P49 due <br /> lignin •this re .• -. RATE eP 1 Tota! "" <br /> winined Signing. celpt,the Generator <br /> IeWor certlfs nsrIf tp bscertifies that a Program has b established to red ,' <br /> Rees that all Hazardous Writs Med on this CPracticaats uce the volume or quantity and t0 <br /> Consolidated Manifest Remi tis �y of the hazardous;waste to a <br /> te:George W.f o P Profiled to Meet the waste t:e as Rated above. <br /> !meet of rise : �T tne.hereby advises theG <br /> doll may be trans enaratorthat X ! <br /> required to Ported to a facility that is <br /> P1Y wlfh the more stringent inquired to comply�,fedemi `s(Generator's signature) <br /> ass.used oil are required to r�tuinsments apP►icab�to h regulations applfcatNe to <br /> IS; These include mote t inose more stringent requirements at8rdaus waste mane management of used oft but that►s R <br /> !Os ure and stringent teak detection and and some out-of�tate 9�rtent facilities, Cati/omia facilities <br /> accidental releases. R iss is Prevention facilities that process that handle or <br /> 3 and not these more we, to send requrrements,engineering certificegon of used on also moo those tequlre- <br /> stringent requirements. used oi(to out of state facilities that coin s tank i <br /> P!Y on rr�9rdY,and financial assure�.t <br /> This notification is for f ►the Federal used oil ane emerrt' <br /> nfotmation only. Lo Driver Si g sfe�cr <br /> :. <br /> Sig attire X <br /> lure of GeneretOri Re resentative or A <br /> P get of Generator. .fit �t <br /> AWS Filter P j!f <br /> 16131 E.Clarrotcgv�nue,Bldg.E ::a cling 1 ri <br /> Ben Drive }: <br /> fn a3Y 61745 Woodvitje M 54028 i J <br /> i!:yct)ng 1.000 7432 P1 -X163. <br /> S,Y t wrRO00028T81 r <br /> :Plities T Aaaran: I <br /> Claus oad ?. r 5300 Rerittos Emrtronmentai otrv.erste z,R: r <br /> Riverbank,CA 96,367 1.515 S.Rhfer Road <br /> 209.863.8181 WOO aacratrregto,CA 88691 ' <br /> CALOON19017 918371-3747 ?r na t I <br /> CAC004003656 <br /> SPAID. j l <br /> , ...._"',.'may.a< � ..•�..'L� .....u,Tu-3'S._.�.�—. � .0<.,M�.V]y...r- 'M•ah•wudq. -... .. .. ... � 1 t •, <br /> ti'd <br />