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See <br /> page <br /> mdeesnigronl ePdrofotercutisoen Agency <br /> eeAgency(12 Sm c California, abs m2050-0039 IEAire9-30-991-pikhfM1jbof Toxi <br /> "2. Pa I Information in the.laded areas <br /> 1. Generate/s US EPA ID No. Manifest Dowmenl No is not required by Federal lar. <br /> �1NIFORM HAZARbOUS D / 7 of 1S8 <br /> Rf WASTE MANIFEST 10 I : <br /> „y -A St M m of of Nomher <br /> Gneroror �� s li <br /> ))�,, <br /> 4. GermaPA ��q /1L.Pf/v•�1���` �4 <br /> —_-- <br /> f77A1,tXPA N CtYi, it _ �_ L�_L—LLL.1.1..� <br /> b. US EPA ID Number -I c Sr to Trayspo) ID(p .ery=d.� <br /> .N S. Transporter 1 Company Nomrs, -- - --- <br /> e0 E#WM9MNMNAL JCYZ AD9B241326Y Ta zp t /s PI Wutl312_529 <br /> 4 0 :E 51 t TfonsPU� ID IP_—cJ 1 <br /> m 8. US EPA ID Nvmbor <br /> 7. Transports 2 Company Name <br /> r� ,F.Transpoticr'z.Phonc <br /> {Q 10.�s EPA ID Number G St t F cil'ny s ID F <br /> .'U Designated Facility Name and Site Address t-- N be 1(y I f 0 14, 19 if 15(��_ <br /> Q srseet ptn-_�r,QpVM� H Facdiys Phone L I_ 1. JJ—� <br /> )nc 1021yB.a�rywRoad]V�a A B 0 5 9 4 9 4 3 1 D J-498-451-50M <br /> �.- 3aaJoce,PiA95133 12. Containers 13. Total 14. Una <br /> Flazard Class,and lD Numbed T Ouanfity Wt/vol I. Waste Nambe: _ <br /> -1 17. US DOT Dasttiplion(including Proper Shippirp teams, - <br /> stale 223 <br /> _ tdat- D M 0 P � <br /> 3 G Hazarftw. <br /> stale — <br /> E <br /> o N b' - EPA/011... — <br /> m E {{�� <br /> v Rum <br /> v A <br /> o T 0�'CQ mlaa7 EPA/cher <br /> ._ R [..P✓ Tv�IX� state <br /> K <br /> m <br /> Z EPA/cher <br /> W <br /> U <br /> W � K. Handliog°CC-ad es kr"Waifez usmd Above <br /> Z 6. <br /> � ea. <br /> d <br /> Z 15. Special Handling Inskvetlons and Additional Information <br /> F 24 Hour€mfg 1�SP0w Tel,No.CHEhfiREC 1-800424-9300 <br /> z DOT EERG 171 Wear protective clothing BBI of Lading# Q✓ i <br /> W .Sales Order# <br /> _ ked, <br /> f <br /> 16. GENERATOR'S CER71FIG710N: I hereby erectors dal dm contents of 1Fiis consignmag an fully and«wr described above by Proper shippi twos ofd are sti.m. ,pa <br /> Q marked,and lobated,and are in all respech in proper condition for transport by highway a«ording In applicable international and national govarnnsent regulations. <br /> U y og y _ <br /> H practicable call <br /> large <br /> t�haltl hav�ensel«led thamp�*cable msalhod oFrtreahnen�.brags,orsdihsposal cuaendy avai(aNe m me wh'ch.iin minis tini pnsenht^d talars tl'a°°t m Irvma healll <br /> and d,e environment;OR,if I am a small quantity ganeraror,I have made o.gZ tai enoA ro minimize my wash generation and select the best waste management method that i <br /> Oavailable ro me and th I con afford. l Abnlh pay Y, <br /> r Printed oma Si alae ,re, <br /> i � () tJ <br /> W T 17. Trans kno A d ement of Rxei t of Materials fY9 <br /> Rw ate / n jpaY/ d R Printed/T <br /> < R i <br /> W <br /> W 1 18. T ns rbr 2 A<krwwled mens of Reni t of Materials ung, pay Y <br /> IT Printed/Typed Name Signature <br /> N E <br /> R <br /> 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> c <br /> F 20. Facility C w..r a rats CertiRcation of recei t of hazardous materials cover this manifest e. t as rated in ban 19. * Day <br /> f T Prmted/Typed Name <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> Blue: GENERATOR SENDS THIS COPY TO DTSYATTHIN 30 DA` <br /> DTSC 8022A 1/991 To: P.O. Box 400, Sacramento, CA <br /> EPA 8700-22 <br />