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����r.Np�v.w vrn0 wa..LVJV�IUJY I[zpires Y-JU-YY) bee Instructions on back Cr age 6. - <br /> Please print or hype. Form designed for use on elite 112-pitch Triter. 9 Department of Toxic Substances Cont. <br /> Sacromento,Colifornio <br /> UNIFORM HAZARDOUS t venerator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br /> WASTE MANIFESTMOD 6 -7 610 O 6 tMani.,f:esIDocumenl <br /> ofis not required by Federal law.Generator's Name and Mailing AddressA. $tNumberBP West Coast Products I LC 22017433 <br /> LO o P.O.Box 90877 B. State Geneator's ID <br /> A. Generator's Phone f 310 )787-4600 Los Angeles,CA 90009 <br /> N S. Transporter 1 Company Name6. US EPA IO Number <br /> LO C. State Transporter's ID[Reserved.] <br /> o Belshire Snvironzn C D 9 $ 3 $ 4 8 1 D. Transporter's Phone <br /> 0 <br /> `p 7. Transporter 2 Company Nome1010 <br /> - <br /> 8. US EPA ID Number E. State Transporter's ID Reseryed.] <br /> 7� <br /> F. Transporter's Phone <br /> r V 9. Designated Facility Nome and Site Address <br /> g ti 10. US EPA ID Number G. $foie Facili 's ID <br /> Q DeMenno K.erdoon U U t_ <br /> -i <br /> 2000 North Alameda Street H. Facility's Phone <br /> l J <br /> CgP?Ptm CA 90222 ICIAT 8 1512 (310)537-7100 <br /> J U 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Containers 13. Total 14. Unit <br /> No. Type Quantity Wl/Vol I. Waste Number <br /> Gasoline Libmwe State <br /> 3 UNI 203 P.G.II 134 <br /> 3 G EPA/Other <br /> N <br /> E b. D M 6 G <br /> oo E State <br /> VAR EPA/Other <br /> o T ` <br /> 00 <br /> Stale <br /> R EPA/Other <br /> Lu <br /> w d. <br /> t- <br /> Z Slate <br /> w <br /> V <br /> us EPA/Other <br /> n J. Additional Descriptions for Materials Listed Above <br /> Z K. Handling Codes for Wastes Listed Above <br /> 2000 North Americea E9rJEEtGFNCY RESPONSE GUIDE NO 128 b. <br /> W The LDR Notification statement is not <br /> aZ EiSC Citancui 251?9 6p. ,rYctdt � lor?y egiriea d as o€Jr95 _ <br /> xt rz <br /> x s^t>L <br /> r <br /> 4 d- <br /> O 15. Special Handling Instructions and Additional Information <br /> Zz Gasoline and Water mixture. Wear rine protective clothing ARCO 4932 BESI# 58931 Foto I <br /> (949)753-5826(24 hoar Emergency phone) 16 East Earth Way LINE. <br /> (949)450-1010(Mom Fri lam to 5pm) Stoci=wj CA SIDE <br /> TAB ff <br /> J 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurate) described above by proper shipping name and are classified,packed, LTIN <br /> Q morked,and labeled,and are in all res cts in proper condition for trans rt b hi hw g applicable <br /> pg eg <br /> V Pe P P po y g ay according to a licable international and national government regulations. <br /> J <br /> hJ If 1 am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> O available to me and that I can afford. <br /> } Printed/Typed Name Signature <br /> V Mon Day Year <br /> Z Moo&a t/RT+'_Cf 85 e f ARCO b <br /> t1 t T 17. Transporter 1 Acknowled ement of cei t of aterials <br /> R <br /> w A Printed/Typed No Signature Monfl� 6ay Year <br /> w P Jv <br /> LL- 0 18. Trans or r Acknowle em"t o Receipt of Materials ' <br /> 0 T Printed/Typed Nome <br /> LU E Signature Month Day Year <br /> Q <br /> R <br /> V F 19. Discrepancy Indication Space <br /> Z_ A <br /> C <br /> I <br /> L <br /> Fn ilitt Owner or Operator Certification of receipt of hazardous materials covered by this manifest exc s no m 19. <br /> Y P.listed/`Typed Nome Signature Month Day Year <br /> r r 0 d � <br /> DO NOT WRITE LOW HI <br /> DTSC 8022A(1/99) White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> EPA 8700-22 To: P.O. Box 3000, Sacramento, CA 95812 <br />