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-'arc or Ubtarreo--enwranmenbl Protection Agency <br /> Fo1m Approved OMR No,2050-0039(Eepires 9.30-99) See Instructions on back of po�. <br /> 'leo:e print or type. Farm designed for ra on dlik(12-pitch)ype Deportment of Toxic Subsrom,"Central <br /> iTso<romeido,California <br /> I. Generabi s US EPA ID No. Nonifasl Document No, 2. Pnge 1 Information in the shaded prem <br /> UNIFORM HAZARDOUS <br /> WASTE MANIFEST �•t t�''''i p: "j} C, +: ) f L. is not required by Fedora[low. <br /> of <br /> 3. Generator',Name and Meiling Addros, VIA <br /> �„+f ,,[) A Stars,ManlfeAf Dacurvcmr Number <br /> . f Gyiyi?1 ,wtJ r3 r' i 23791253 <br /> i <br /> Snae GeMwaar's ID <br /> 4. Generobr'e PhoneP(t;,J y �Jv/1.r' <br /> V 5, Tronfpafler 1 Company Nome ' d. US EPA ID Number <br /> n r v •fi]9p�9 C. Store TrampaykYs rD esened,j <br /> SYR INV TWKrfA eq r.FA1r f <br /> o SFS' 4: 15 1) :) 14 4 :� a° a 12 <br /> D. Tronepatkr's shows <br /> wq �,p�o� � es.r . US EPA ID Number <br /> 9. 8 <br /> barirl(�`4 tiid9�:y.fl3tr$i.s4 .y.7S� '�r, t:, sraro Trcnsparier':1D F�4. +] ] ' <br /> �A)A aSi�IZWe <br /> i7 "y 6 4 7 986 f. Tronsporkr's Phare <br /> V. Doslgnoted faccii[ily Name and Site Address 10. US EPA ID Nrmber G, Store FaydMyuf ID <br /> 7 �Ss.�TJ.nW4•v r 1�3� �� <br /> r l� � ! tT�e'' �s H. AaaNiy's Phoria <br /> MY, A1' 3i i+T!!I3 � R .) {•> A 0 8 $ 5 try ak a <br /> j 111. US rDPT Ducripti>n(Including Proper Shipping Nome,llemrd Closs,and ID Number) 12. C.Ma'nas 13. Total 14. Um, <br /> r Na' Tore Quantity WINoI 6 Waste NumbS.� ' <br /> d 1r .rp4 I Slafe rr+' <br /> r <br /> 0 <br /> I leo.►1d Disposal e5 n� ion6. " N <br /> a A EPAlOdsr . <br /> 7 <br /> oO state <br /> R OANDRIaI i <br /> > Seas <br /> u ! <br /> J EPA/Odw <br /> u <br /> y g., dDes-,ptiom For A%Wok Usled Abwe K Naraag Cis b Warta ListedAbave <br /> u I <br /> e <br /> All <br /> j 1S. Special Handling Instrvctions and Additional Inlomntior,/ <br /> J f A'{ :-j I.e:i!Yrs rYffe• .AD ,�..�_ • . � t <br /> E .4r�A,yay�T+ qy y��y'3a T7� (Y� Ay ,v,r�/E(`5 yeys y1.41. <br /> 4,�^i <br /> j3'�r � <br /> -1 R612YflG d91.'xi i.Yi..3. 1�3`. �/Y.J4Y.Lf��6Y`,a 11A R'y m ggy+ V <br /> vF.i.il"n. j. <br /> 16. GENERATOR'S CERTIFICATION: Iherehyd¢doretholfhacantents efthis mnei9nment aref�lly and aauraroly described chore by proper shipping tame and ore classified,packed, ' <br /> marked,and labeled,and arc in all respeae in proper condition for transport by highway occorr7ing to croplimhk international and norionpl government regulations, i <br /> iI <br /> If 10111 o large gmnfiy generpror,I<eAify that haw a p rom in pl«e to reduw the volume and ?a of waste gene h c!ro tho degree;have determined b be«onomieclly <br /> j proclim6le end that t fq.s tie mkd dre praeticabla method of neohnent,voroge,or disposal eurren8y ovoifable re m which mint mites the present and furure threat ro human healH'i <br /> acrd the a"'Ins" enk;OR,if 1 mm a smolt quantity genMabrr I how made a good foith effort b minimize new wart geneedfian and selacr the be weak t method Ihaf iz <br /> available tome and their l count afford. r a�^ie^ <br /> "r-trellName $i nakn <br /> e <br /> .W <br /> p�V 1',.r�_(.r k�.•p '....,�� 11 i j : '� t 1 1 ' , A1�� � " �. <br /> Trona 'Avlknowlediresment of Reco aF McMials Z' <br /> R <br /> j e Prkted/Ty 1Ra e P rit <br /> Si mN ip'" 1 , tN <br /> R18. ronA tree 2 Ackaowl morel of Recei t of Materials <br /> E mild/Typed Name Sigoawre Month Do Yevr <br /> y <br /> C A i <br /> 3 19, Discrepancy in !=I"Space <br /> Is <br /> = A <br /> C ' <br /> 1 I <br /> L I <br /> I 20. Facili P. r or O tarot Grrificotivn of tenet t of hozorslars materials covered b this mani{est t <br /> as noted in 1 19. <br /> Y Primed/Typed Name '• 5gnarure North Day Year <br /> i <br /> DO NOT WRITE BELOW THIS UNE. t <br /> )TSC 8022A (1199) 7 <br /> :PA 5700--22 Y-110w; GENERATOR RETAINS , l <br /> 6 'd d096' ON Wd[t: C 9002 ' 9l ' unr <br />