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NON-HAZARDOUS WASTE MANIFEST <br /> Plwee print or type (Form designed for use on aide 112 pitch)typawrlterj <br /> NON-HAZARDOUS 1.Generat etiUSEPA ID Na Man#est 2 Page 1 <br /> Docurreni Nc- <br /> ";v WASTE MANIFEST 1 <br /> 3.Ganerstor's Name and Mailing Address <br /> Trinkle & Boys <br /> x 31244 South Highway 22 <br /> TracV, CA 95309 <br /> 4.Generators Phons(209 ) 467-1006 <br /> 5.?tanspnrter 1 Coronary Name 6. US EPA ID Number A.State Tanspoder's ID <br /> Advanced Chemical Transport CAR000070540 B Transporter 1 Phone _ — <br /> k <br /> T.Transporter 2 Compary Name 8. US EPA ID Number G.Stats Transporters ID <br /> Q.Transporter 2 P:'tcne <br /> 9.Designflad Fediity Name and Site Addresa 10. US EPA ID Nurt>Der E.State Facility's 10 <br /> Inetrat Inc CAR00d150599 <br /> t` 1105 C A,i=part Rd F.Fadl"Phone <br /> Rio Vista CA 99571 530-753-1829 <br /> 11 WASTE DESCRIPTION Containers 13. 14. <br /> Total Unit <br /> No. Type Quantity WtJVV. <br /> K� <br /> a <br /> Non Hazardous Waste Liquid (� f-� C' <br /> G <br /> E <br /> N <br /> E <br /> R <br /> A <br /> T <br /> R d' <br /> fl H.Harding Codes to.,Wastes Listed Above <br /> G.Additional Descriptms for Materiels listed Above <br /> r., <br /> e 15 Special;-landline Ins4uctlons and Additional InfomlaNrn <br /> TRT-O✓( C7 0 2- <br /> r r . <br /> Project Number: CV01729-01 <br /> W", r �. ,NV, � rte .. ,. AN <br /> - � <br /> Aff Aff 3 . <br /> 16 GENERATOR'S CERTIFICATION:I hereby certify that the contents of this sh',pment are fully and accurately described and are in all respet's <br /> _',: m proper condition for transport.The materiels described on this manifest are n <br /> not subject to federal hazardous waste regulations. <br /> `G : <br /> Date <br /> "i <br /> 'AcrM Day Year <br /> PrirtledRyped Name <br /> U <br /> Date <br /> T 17. Trarupatar 1 Acknowledge rt of Receipt of Materials <br /> A Pr ed Narru Signal r ISMrMh Cay Year <br /> IS <br /> P Date <br /> 0 18. Transporter 2 Acknowledgement of Receipt of Materiels <br /> R Sicnatu e Month Day Year <br /> T PrintedrTyred Nflne <br /> E <br /> R <br /> 1 <br /> F 9.Discrepancy Indication Space <br /> A <br /> C <br /> 20 Fec7ldy 0mner or Operator Certification d receipt of the waste materials oovared by this manifest.ex es noted in Clem 19 <br /> L Date <br /> T PrSni""fypedName Day Year <br /> Y <br /> CF14 02002 LA6ELMASTEtt® (800)621-5608 wNw.labe',master.com <br />