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State of California—Environmental Protection Agency <br />Form Approved OMB No. 205(Y -0d39 (Expires 9-30-94) See Instructions on back of Department of Toxic Substances Control <br />?tease onnPor ryoeForm desianed for use on elire (12itch) "W to Sacramento, California <br />DO NOT WRITE BELOW THIS LINE. <br />Blue: GEENERATCR SENDS TMS CCPY TO DISC 'WITHIN 30 DAYS. <br />DTSC 8022A 112/91) To: P.O. Box 400, Sacramento, CA 95812-0400 <br />EPA 8700-22 <br />1. Generator's US EPA ID No. Manifest Document No. 2. Page I <br />Information in the shaded areas <br />UNIFORM HAZARDOUS <br />is not required by Federal law. <br />WASTE MANIFEST <br />G AI D 11 q 0 ij Z 9 31 of 1 <br />3. Generator's Name and Mailing Address <br />A. State Manifest Document Number <br />BF CHEMICAL INC. <br />921-629-39 <br />3437 SOUTH AIRPORT WAY, STOCKTON, CA 95206 <br />B. State Generator's ID <br />4. Generator's Phone ( 209 983-3339 <br />5. Transporter 1 Company Name b. USS EPA ID Number <br />C. State Transporter's ID 7 <br />'7� <br />Transporter's PhoneiP <br />�fjL+]2��f ff 1, <br />7. Transporter 2 Company Name 8. US EPA ID Number <br />E. State Transporter's ID <br />F. Transporters Phony <br />9. Designated Facility Name and Site Address 10- US EPA ID Number <br />G. State Facility's ID <br />NORRIS ENVIRONMENTAL SERVICES <br />5215 SOUTH BOYLE AVE. <br />H. Facility's Phone <br />LOS ANGELES, CA 90058 C1 Al DI 01 91 71 0 31 0 <br />11, US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) <br />12. Containers <br />13. Total <br />Quantity <br />14.Unit <br />Wt/Vol <br />I. Waste Number <br />No. <br />T <br />a }} WASTE CORROSIVE LIQUID, N.O.S. (SULFURIC <br />state 792 <br />ffd61`;D007,D00 <br />MATERIAL, <br />7 <br />{� <br />E <br />E <br />(#6IVE <br />UN160 ERG0) <br />T T <br />G <br />N <br />b. <br />State <br />E <br />EPA/Other <br />R <br />A <br />T <br />c, <br />State <br />O <br />EPA/Other .... <br />R <br />d. <br />Stole <br />ERA/Other <br />J. Additional Descriptions for Materials Listed Above <br />K. Handling Codes for Wastes <br />Listed Above <br />a. water 60-72%, SULFURIC ACID 22-30X, SODIUM DICHROMATE <br />a. <br />b. <br />6-10x. <br />c <br />d. <br />15, Special Handling Instructions and Additional Information <br />a. E1065300002CR 24 HOUR EMERGENCY CONTACT: (209)982-01.60. <br />WEAR APPROPRIATE PROTECTIVE GEAR WHEN HANDLING. <br />PLEASE INVOICE CUSTOMER #RO8271 <br />6. GENERATOR'S CERTIFICATION: I hereby declare that the contents of the consignment are fully and accurately described above by proper shipping name and are classified, <br />I <br />pocked, marked, and labeled, and are in all respectsin proper condition for transport by highway according to applicable federal, state and internationoi laws. <br />If I 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 <br />economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future <br />j <br />threat to human health 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 <br />waste management method that is available to me and that I con afford. <br />I <br />Printed/Typed Name <br />Signature <br />Ma nth Day Year <br />K, KtTt4CawA <br />D D 1-7 12- <br />ZTLoN <br />'T <br />17. Trans orter 1 Acknowled ement of Receipt of Materials <br />t a <br />A <br />N�_F_ <br />f ped amt <br />Month Do Yaar <br />a18, <br />Transporter 2 Acknowledgement of Receipt of Materials <br />T <br />Printed/Typed Name <br />I Month Da Year <br />Signature Y <br />p <br />I <br />19, Discrepancy Indication Space <br />C F <br />3 A <br />C <br />- I <br />I <br />20. Facili Owner or O rotor Certification of receipt of hazardous materials covered b this manifest except as noted in Item 19. <br />T <br />Printed/Typed Name <br />Signature <br />Month Day Year <br />Y <br />DO NOT WRITE BELOW THIS LINE. <br />Blue: GEENERATCR SENDS TMS CCPY TO DISC 'WITHIN 30 DAYS. <br />DTSC 8022A 112/91) To: P.O. Box 400, Sacramento, CA 95812-0400 <br />EPA 8700-22 <br />