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Stott(t California—Environmental Protection Agency <br /> Form Approved OW No.2050-0039(Expires 9-30-99) See Instructions on back of s 6. Department of Toxic Substances Control <br /> Please print or type. Form designed for use on elite 112-pitch)typewntec. Sacramento,California <br /> 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br /> UNIFORM HAZARDOUS <br /> WASTE MANIFEST is <br /> onot required by Federal low. <br /> jqjgjWqj <br /> O Q O l { <br /> 3. Generator's Name and Mailing Address A. State Manifest Document Number <br /> ARCO Products Company 20125149 <br /> O P.O.BOA 90877 B. State Generators ID <br /> io <br /> A. Generator's Phone( 310) 342-9858 Los.ArIgeles,CA 90009 IKI FJ 3 1614 11012101 <br /> N 5. Transporter 1 Company Nome 6. US EPA ID Number C. State Tronsporter's ID[Reserved.] <br /> W) <br /> W <br /> rter's Phone <br /> o Belsl&e Environmental Services,Inc. C Al918 131518141618 1 D. Trans (949)450-1010 <br /> co 7. Transporter 2 Company Nome 8. US EPA ID Number E. State Tronsporter's ID[Reserved.) <br /> J Asbury Ihvironmental Services C1 kj 0 01218121 -71-710 3 6 F. Transporters Phone <br /> rQ <br /> U d Facil Na a and Site Address 10. US EPA ID Number G. State Facility's ID <br /> Q 9. 1J�M@71110 f?T�Oon <br /> Z 2000 North.Alameda Street QJAI <br /> �06 H. Focility s Phone <br /> �O Cornpton,CA 90222 Tj O 1111 010 111 313 2 (310)537-7100 ti <br /> J 12. Containers 13. Total 1 A. Unit <br /> a 11. US DOT Description(including Proper Shipping Nome,Hazard Class,and ID Number) ` <br /> V No. Type Quantity Wt/Vol 1. Waste Number r <br /> Z a. Gasolwie a State 134 <br /> 3 UNI 203 P.G.If <br /> 3 G (Not Re[ 1laied as a RCRA Waste) G EDA/ <br /> E b. State <br /> o N <br /> a°Do E <br /> R EPA/Cither <br /> A C. State <br /> o T <br /> °o° <br /> R EPA/Odw <br /> R <br /> LU d. State <br /> 1-- <br /> Z Z <br /> LU <br /> v EPA/Other <br /> J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above <br /> 1996 North American MdMCTENCY RESPONSE GUIDE NO. 128 a- �, b- <br /> Ln W The IDR Notification strtemenit is riot reglured as of Jarnmary,1996 <br /> J <br /> HSC Citation 25179.6 d. <br /> Q <br /> Z 15 Seciol Handling Instructions and Additional Information <br /> Cera Ime and Water mime. Wear appropriate protective clothing ARCO 4932 BESI# 27843 <br /> Z (949)753-5826(24 hour Emergency Phone) 16 East Harding Way <br /> _ (949)450-1010(Mon-Fri 7am to 5pm) Stodctcwi,CA <br /> ::j 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, <br /> Q marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> V <br /> J If I am o large quont. generator,I certify that I have o program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> n practicable and that I have selected the rrocticable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> sn 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 /> oe available to me and that I can afford. <br /> O <br /> >- Pnrtied/Svo a5�rt of ARCO Signature Month Day Year <br /> Z <br /> W <br /> (.5 T 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> Cie 'A Printed/Typed amt Signature Month Day Yea <br /> w R <br /> :�E S l [� 7 U <br /> w <br /> sa_ 0 18. Trons orter 2 Acknowledgement of Receipt of Materials <br /> O R <br /> T i <br /> Prince Nome Signatu Mon Day Year <br /> LLi <br /> N R C� U U G <br /> a <br /> U 19. Discrepancy Indication pa e <br /> Z F <br /> A <br /> C <br /> I <br /> L <br /> r 20. Facility Owner or Operator Certification of receipt of hazardous materials covert anifest except as noted in Item 19. <br /> Printed Nam Sign ure Month Doy Year <br /> ae v 7 v7 1 () lo <br /> DO NOT WRI LOW THIS LINE. <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 />