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.Ymv auvv DCC ensFFUCT1OnS on DOCK or page o. <br /> ..m e,�gnsd rot ase on shb f 12 p,,ehl typewritertypewriterDePonmem o lout Subtloncm.an•: <br /> d _ <br /> e Socromenro.Cdbfoma <br /> UNIFORM HAZARDOUS Generonse's US EPA ID No, Menthe D...., 2 Page 1 nforvi in!M shaded Press <br /> WASTE MANIFEST "`fj AlL 0; 0i 0101 1191311161 �0 2 113 1 of. 1 "wet required by federal low <br /> 3. G.....o�r'I Naammee ore Moiling Address A. Stan.Mnifest <br /> e aDescumem Number <br /> WESPR 1 98771o'-3 n <br /> O <br /> 4101 ARCH RLIAD 9, Slate Generator's ID <br /> A GA-AXXKV, CA, 95215 <br /> N I 5 Tramporhr I Compe-r Nome 6. US EPA ID Number C. $orb Trantporbr't ID <br /> ut <br /> m <br /> o NATIONAL RF50EJRCFS CAT 9 8 2 5 1 8 4 3 3 D. Transport.,,Phone <br /> oa 7 iron Doer 2 Compo- name <br /> p y 8 US EPA ID Number E. Store Lonsponer's ID <br /> Q F. Tramponer't Phone <br /> 7 V 9 Designated PoeOty Nome and S.I.Address 10. US EPA ID Number G. State fac0ity's ID <br /> a AMERICAN ROODV RY, INC. 1 / <br /> 0 3033 W. MIMICK ROAD N. facility's Phone <br /> _ AL A, CA 91803 ICIAIDIO1819141416 71,110, 626-458-222:, <br /> 'U 11. US DOT De,oi non - 12. Comoiners I7_ Total 14. Unit <br /> p (including Proper$hipping Name,Hazard Class,and ID Num6erl <br /> No 1 Type Owneiy Wt/Vol I. Waste Nvmber <br /> Z a. Stale <br /> Scr <br /> 3 G —_ �'� SC• EPA/Other <br /> o N b --r _ _ __ri�y� � Sara <br /> m <br /> Q e R ' EPA/ <br /> Ohe <br /> to-Rv— 411911. i1mrA <br /> O =' VC� CC v1 y l � `e c Swas <br /> , p\m O I. fe— O 11 t"t E� — <br /> ' <br /> / EPA/Other <br /> R 2 9 3 1 um_ C W <br /> d. Sean <br /> Z <br /> W <br /> V EPA/Other <br /> W <br /> Z J. Addieionol De,oipnons for Mo,enols fitted Above K. Handling Codes for Waste,Wad Above <br /> P. Is. <br /> N q-fm <br /> ahSc wT all fllCed oi � Ply 4SDa3 �i/ d. <br /> 0 I S. Special Morseling Instructions and Additional Information Y, <br /> P= WEAR PROPER P.P.E <br /> Z 24 HOUR EmERGENCY co TI'ACr $ 800-424-9300 <br /> w <br /> x <br /> I- <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare else,the coretenh of this consignment ore fully and accurately described above by proper shipping name and an classified.Pocked, <br /> marked,and obeled,and are in all respect in proper condition for transport by highway according Ip applicable international and notional government regulation,. <br /> V <br /> If I am P forge quomby generator, I certify that I have a program in place to reduce the volume and toddy of wash generated to the degree I have determined to be economicai•r <br /> H practicable and that I hove selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> ed <br /> and the nronni OR,if I am a smaquantity generator,I have made o good faith effort to minimize my waste generation and select the best waste management method that s <br /> available to me and that I can afford. <br /> O <br /> y Pea /Tyee;L.Npme S' Morals Day Ye. <br /> Z C/GAN1C I'l(�`L1�1if� <br /> W ! 12. Trans orter I Acknowled ement of Receipt of materiels <br /> w j Ainhd/Typed Name Sign Month Day Yea <br /> w 5ALv►4 c 6fA{2 c, ,^ D 61 l� 9 <br /> O E 19. Trans er:er 2 Ack,c.'ed=e,,n,of Pectic,of Mahriols <br /> I Pr.med/Typed r-r,a Signature Month 0cY .. <br /> w E <br /> vs i p I i <br /> Q: <br /> V 19 Discrepant. Indac c..5racz <br /> ZI A <br /> C <br /> 120 Facili 0-1c,o Oc or Ceshceoion PI.ace t of hazo.dow mater' Is covered by this monife,t except as noted in Item 'c <br /> T Pnmedi Typed'<ume Signature Month DcY Yen, <br /> Y L� U C= C7 \ 1'� ' WOO 4v ,,.o r- �clol.o! <br /> DO NOT WRIT BELOW THIS LINE. <br /> D75C 8022A 14/971 <br /> EPA 8700-22 <br />