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State of California --cm ironmental Protection Agency r <br />Form Apprord OMB No. 2050-0030 IE■phos 9.30.991 See Instructions On :SOCK Of 4#ge 6. Department of Toxic Substances Control <br />Please print or typ-. Form designed for use on dire f 12•ptichl typewriter. 5ocramonro, California <br />4 <br />Cog <br />LOW <br />coo <br />"0.4 Q <br />N <br />O <br />co <br />co <br />v <br />at <br />v <br />O <br />Go <br />Cd <br />W <br />1— <br />z <br />W <br />v <br />W <br />tss <br />z <br />0 <br />a <br />z <br />0 <br />a <br />z <br />W <br />Q <br />V <br />L <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A 14/971 ' ^ _ White. TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-22 - To P O. Bos 3000, Socran»nto, CA 95812 <br />UNIFORM HAZARDOUS <br />1 Gonerow's US EPA ID No. Manifest Document No. <br />IC <br />2. Pogo I <br />Information in the shaded areas <br />i. Trot required by Federal low. <br />WASTE MANIFEST <br />140 0 0 D I 01Z1015-1 8! 8 1 6 <br />b 1 2 <br />of 1 <br />3. Generator's Name and Moiling Address <br />A. Slott Manifest DoewrAw Number <br />TOSCO MARKETING CO. ATTN: JANETTE THOMPSON <br />98088662 <br />la. Sims 0"~s m <br />2000 CROW CANYON PL. #400 SAN RAMON, CA. 9.4583 <br />4. Gemeraai s ane 1510.' 277-2305 SP SITE #IttJ5 <br />1H 11 1H IQ 14 1410 131612 14 14 <br />5. Transporror I Company Nome - 6. US EPA ID Number <br />C StatuTrompor * * <br />CALIFORNIA HAZARDOUS SERVICES IC IA R P 10 10 1011 11 7 11_18 <br />0714) 434-9995 <br />7. Tronsporter 2 Company Name 8. US EPA ID Number <br />E. Sae Tromporter'& ID <br />I I I I I I I I I I I <br />F. Tronsporleh Pltorw <br />9. Dosrgnared Facility Name and Site Address 10. US EPA ID NumL%or <br />G. SbteFocffilT''s ID <br />ROMIC ENVIRONMENTAL TECHNOLOGIES CORP <br />IC IA ID 10 10 19 4 15 1?J6 15 17 <br />2081 BAY ROAD <br />r1. FadwsPhaim <br />EAST PALO ALIQ-0 CA 9A303 L- 1A 11) h h 19 14 IS 12 LLL <br />4IR 4-1AXR <br />It. US DOT Description (including Proper Shipping Noma, Hazzard Clots, and ID Number) <br />12 Containers <br />13. Total <br />Ouontity <br />Id. Unit <br />wt/Vol <br />1. Wage Number <br />No <br />Type <br />a. <br />Slate <br />WASTE FLAMMABLE LIQUID, N.O.S. 3 UN1993 PG II <br />133 <br />EPA/O dW <br />0001 <br />G <br />(GASOLINE) RQ0 <br />1 <br />N <br />It. <br />Stet. <br />� <br />t <br />EPA/Qdtsr <br />A <br />T <br />C. <br />State <br />0 <br />EPA/Other <br />R <br />1 <br />d. <br />State <br />J. Addi*nol Descriptions for Mase Ws Usted - <br />k Handling Codes for Wastes <br />Listed <br />I J_A GASOLINE <br />a <br />b, <br />WATER - <br />C. <br />a <br />15. Special Mandling instructions and Additional Informalion <br />P PROPRIATE CLOTHING AND RESPIRATORS PROFILE # 219268 BP <br />SITE: # I1�g5 <br />L�• VISE n1�. <br />4 HR. EMERGENCY CONTACT: <br />t(oseno <br />HEMTREC 1-800-424-9300 <br />I-ATh4 T C <br />16. GENERATORS CERTIFICATION: 1 herby dsclaro that the contents of this cosigomen: are Ulyand accurate) described abo.�s by props. shipping name and are classified• pocked, <br />needed, and labeled, and are in all respect► in proper condition for transport by highway csccoding Ic opplicable international <br />and notional go.ernment regulations. <br />If I am o largo quontiry gmerala, I certify that I how a pr ram in place to reduce the -plume and toxicity of waste 9~oted to the degree I ho" determined to be economically <br />which Iuturo human Freohh <br />practicable and that I haw selected the practicable method of treatmont, storage, a disposal curr.ndy owilablo to <br />me minimizzes the prnsant and Ihrwt b <br />and the awiroament: OR, if t am o Niall quantity generator, I hc" mode a good faith offoo to minimize my was* <br />generation and select the best waste management method that is <br />o.ailable to me and that I can afford. <br />Prin /Typed Nacos /j�' Signotu <br />Month Day Your <br />klzmaeo S' 25 <br />T <br />17. Trans I Ac:nawGd t al' Rscsi tof Materials <br />R <br />A <br />Prmted/l YPed Non* <br />Signaw <br />Manch Day Your <br />1691604 C'�R�'0 L C, <br />if 2 L/ g <br />P <br />g <br />IB Transpater 2 Acsnawled ement of Receipt of Motetials <br />R <br />T <br />Printed/Typed Nome <br />Sign re <br />Month Day Year <br />E <br />R <br />' <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />1 <br />t <br />20. Focili Owner or Opwatof Certification of reeei 1 of horordous mo*rials conned by this manifest axes t as Hated in (rem 19 <br />T <br />Prin*d/T Nome <br />Sigrwwn <br />Month Doy Year <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A 14/971 ' ^ _ White. TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-22 - To P O. Bos 3000, Socran»nto, CA 95812 <br />