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omental Protection Ag. <br /> ,.2050-0039(Expires9-3vcp9) See Instructions on oack of page 6. <br /> nn designed(or use on elite(12-pibhl typewriter. P 9 Department ra Toxic vs bsb <br /> ��ii"""" Sacramental Califo <br /> NIFORyMAZAR60US I. Genmeb/s US EPA ID No. Marled Document No. 2. Page 1 bformotion in the shaded are <br /> €€ Q I a 9 7 of I i, EES8 Federal la <br /> WAST MANIFEST <br /> 5enemro ame li ,�r,,� A. State Manifest Document Number A <br /> mss ` ' - 2175f <br /> 20P <br /> Z' <br /> / B. State G erator',ID <br /> A. Generator's Phorw Q 1. �y y� � + 7r � O%ox 1 e 6 v+ 1 <br /> 5. Transporter 1 Company Name 6. US EPA ID Number CEVOWStale Tranzpoder'z ID(Reserved.] <br /> tIEPIVIRMWAL SUMD. Trans ter'z Phone <br /> AD98Y413Y62 p°` MM E72-SM <br /> 7. Transporter 2 Company Name S. US EPA ID Number E Stale T,—sporter'z ID(Reserved.] <br /> .J <br /> ._�� E Traniponer's Phonu - <br /> 0 . Designated Facility Name and Site Address 10. US EPA ID Number G Stafo f°dbys ID <br /> 7Z 1�1NJOSt �et*n {{i 6avl.S�Sn+.TrPs� L+-G G A ID 1015 X914 19 1 4 1 3 LUO <br /> ')0 ae 1821 Balpesil H Fadlity',Phone <br /> .. SaBJose CA 95133 A D 0 5 9 4 9 4 $ 1110 1-4011451-M <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12..ContaT Guiners Total W Unite <br /> Noanty wt/vol 1. Write Numbe <br /> �_ ltexardbus waste, Solid sta a 223 <br /> E b <br /> N State <br /> m E <br /> a A "�1 <br /> o T <br /> State <br /> W 0 <br /> R EPA%ah <br /> W d. <br /> Z <br /> W <br /> U <br /> W <br /> Z dddionol.Deseriphons for Mater o6 fslodAbove a'<' <br /> O <br /> z L <br /> 0 15 Special Handl ng Iro,wioe,and Additional l Fo nation <br /> a 24 Hour� se Tel.No.CNEWKC 1-8(!0-424-9300 �J <br /> W DOT ERC,17f Yiear protective clothing Bill of Lading# <br /> Sales Order# j t <br /> J 16. GENERATM5 CERTIFICATION: I hereby declare that the content of this consignment are Fully and aavrvle�y descriF»d aF»ve!y proper shipp'ng name arsd an edassiked,piked, <br /> QU marked,and labeelad,and am in all respects in proper condition for transport by highwoy according b applicable intematiormf and rgBorwl government regulations. <br /> -� If 1 am a large quantity generator,I certify that I have a p ram in place ro reduce the volume and toxicity of wash ganeraNd ro the degree I haw determined te be aconomi <br /> ypredicable and dM I aw selected the predicable method of treatment,sbrvga,ar disposal currently awilable b me which minimize flee ppresent and tenure threat b he.h, <br /> and the environmanY,OR,if I am a small quan8ty generator,I hwe ma a tett effort b minimize my wash gamm8on and select 8u best wash management method th <br /> O. available ta ma and I can afford. <br /> y Pries ed ame Si ab Montle Day <br /> z b t <br /> O, R 17.Trans rte Acknowled anent of Recei trot Materials <br /> W A Printed/Typ e / alar // <br /> E ,�( <br /> W E <br /> W 0 18. T n r 2 Ackno erases(of Rxsi f of Materials <br /> 1 Printed/Typed Name 5igiwNrs MoNh Day <br /> N E <br /> E <br /> 19. Discrepancy Indication Spam _ <br /> Z F <br /> _ p <br /> C <br /> I <br /> L <br /> 1 20. Fadlity0wnerorrotorCwflficationofr"pt*fhazardousmt.rialsovered this marifest-axcept as noted in Rem 19. <br /> T Prinied/Typed Name Signfibre Month Day <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A(1/99) Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DF <br /> EPA 8700-22 To: P.O. Box 400, Sacramental CA 95812-0400 <br /> I <br />