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7 <br />..trental Protection Agency <br />1050-0039 (Expires 9-30-99) See Instructions on back of a 6. Department of Toxic Substances Control <br />arm designed for use on elite ()2 -Fir"" typewriter. Sacramento, California <br />M <br />DTSC 8022A (11/99) <br />EPA 8700-22 <br />DO NOT WRITI ELOW Tr/LINE. / " U <br />White: T5DF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />To: P.O. Box 3000, Sacramento, CA 95812 <br />1. Generators US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br />UNIFORM HAZARDOUS <br />is not required by Federal law. <br />WASTE MANIFEST <br />of <br />3. Generators Name and Mailing Address <br />Toys-R-Usr`` <br />A SIagsbvj4i+pAl�tpllter <br />1624 Army ct.: <br />Stockton, ca 95206 <br />fs; 1s�q� r . <br />, <br />ern <br />A. Generators Phone (209 1465-4942 <br />t j1 wyV' r'� I kfi <br />5. Transporter 1 Company Name 6. US EPA ID Number <br />, S1s1 iiDF <br />C..D. <br />// v <br />< , 29IN <br />TTS ENVIRONMENTAL INC. 6 <br />7. 2 Company Name B. US EPA ID Number <br />E. Stoll ;}- <br />/Transporter <br />F. Tran <br />9. Designated Facility Name and Site Address 10. US EPA ID Number <br />G:, <br />CROSBY-OVERTONr' <br />1630 West 17th St. <br />, <br />H. t=oe sP a <br />LONG BEACH, CA 90813 <br />x 4 i ' <br />11. US DOT Description lincluding Proper Shipping Name, Hazard Class, and ID Number) <br />12. Containers <br />13. Total <br />14. Unit <br />`" ?w�1t'S„iffvt <br />No. <br />Type <br />Quantity <br />Wt/Vol <br />a Non-Rcra Hazardous Waste Solid (Diesel. <br />Filters) ERG#171} <br />G <br />P <br />D t4 <br />9 P P <br />P <br />Ee y <br />b. <br />SloIR <br />N <br />E <br />EPA/Other <br />R <br />, . .�.. <br />Aa <br />C. <br />S1°teTX” yt <br />O <br />i <br />d. <br />J: Additional Descriptioris fol Mc 'rihfl3 *\,• � Y �{° ryryf'j ' <br />-•a6 ."'�Vyl r+yN�' <br />stu 'v.7.•`'bi,3 �� "�T'� <br />IC:' H <br />.a fd. ., t . Nasfes <br />List t � yW l Y$ R <br />"Y`Y ,. <br />a "�Y i <br />'`'''' <br />rwt;t 5'°•*,��r <br />� Y' �"({ ��.�; 4"�t.r. ��<S :e.>.�./�s5r `�.`�•�. as%.:� � vZ tL's,�,,4 <br />.i <br />0439..,., <br />RE; <br />� <br />wl•'.•i <br />'rS ,v i ' <br />�`�'�'o`t ,s',� > <br />C <br />4. 41 <br />... CSS <br />4 hZ C�,�'°�'R•\y_�,`,?\!' <br />[ �C1l.L <br />Y.}�: ?` z 5 �^C` tri•�.'t m�'�'� f+%i��{.�il'+`�'c. �,�-`G�k 1� <br />4 X f :aa <br />r � '1�,. �, ��..s ?'.r .F <br />a.`i <br />15. Special Handling Instructions and Additional Information <br />Emergency Response # 786-7645 (Fremouw Enviornmental) <br />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 />for transport 6y highway according to applicable international and national government regulations. <br />marked, and labeled, and are in all respects in proper condition <br />IF I am a large quanti 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 />disposal available to me which minimizes the present and future threat to human health <br />practicable and that I have selected the practicable method of treatment, storage, or currently <br />and the environment; OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste <br />generation and select the best waste management method that is <br />available to me and that I can afford. <br />Printed ped Name <br />Si nolo <br />Month Day Year <br />Q 10, <br />T <br />17 Tran orter 1 AckpIllowled ement of Recei t of Materials <br />Month Day Year <br />RPri <br />yped Na Signature <br />^ <br />N' <br />S <br />lollP <br />I <br />18. sorter 2 Acknowledgement of Recei f Materials <br />R <br />Prin d Name Signature <br />Month r <br />T <br />E <br />/41 <br />R <br />c p Indic on 9pa6 <br />Ell <br />F <br />A <br />C <br />I <br />L <br />I <br />20. FacilityOwner or erator Certification of receipt of hazardous materials coveredAY11Wtvioni6st except as noted in Item 19. <br />Day Year <br />T <br />r <br />Printed/Typed Name Sig re <br />Month <br />M <br />DTSC 8022A (11/99) <br />EPA 8700-22 <br />DO NOT WRITI ELOW Tr/LINE. / " U <br />White: T5DF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />To: P.O. Box 3000, Sacramento, CA 95812 <br />