Laserfiche WebLink
-vi <br /> �plateRC l'1 PMS No onmen�IProt•ctronAgenq, P 1' rhr. page Department of Toxic Substances Com <br /> Farm App o ed OMB For 2050X]039,,))ffppya�� 9-�a p�_� T '� See Instructions on back of a e 6. <br /> Pleom e. Form deli reed F2Fesetdl ic(h '7P^"'' '�',�,' r i Sacramento,California <br /> UNIFORM HA7ARDOUS « US EPA .feo. A1anilast Document No. 2. Pap• 1 Information in the shaded areas <br /> C1 Al T.101 Q1 011111110111511� +� not regained by Federal law. <br /> WASTE MAIJIFEST n 1515111 <br /> - <br /> of <br /> 1.43•rwralor's Nome and flailing Address <br /> U.S. RENTALS Tld. <br /> $ 2081 Re aWTER WAY, STOCKTON, CA 95205 <br /> n 4. Generator's Phone( 209) 948--9241 <br /> aN 5. Transporter 1 Company Nome 6. US EPA ID Number rohispbrlir'i ro <br /> C (016) 371-57 <br /> 'Trbnsporhx s PAdsse - <br /> 7. Troespoeter 2 Company Name 8. US EPA ID Number <br /> 9. Designated Facility Nome and Sib Address 10. US EPA ID Number <br /> CHEMICAL WASTE MANAGEMENT, INC. { { <br /> 35251 OLD S%YLINE ROAD, KETTLEN,AN CITY, CA 93239 Fat ysPhane <br /> ,(p CAT000646117 209. 386-9711 <br /> LIJ? 11. US DOT Description(including Proper Shipping Name,Hazard Chu,and ID Number 2. Containers 3. Total 14. Unit <br /> cliz P li g ps ppi g 1 No. Type Quantity Wt/volllllllillf�toste Number <br /> NON—RCRA HAZARDOUS WASTE SOLID 223 <br /> �3 c (OILY SOLIDS) NAERG96#171 0 other <br /> E 011011 b. <br /> N <br /> m E <br /> a R steer <br /> NV A <br /> T c. <br /> m 0 <br /> R Ohher.. <br /> asc 4 <br /> F d. <br /> Z <br /> w <br /> U <br /> w i <br /> Y .: _.. <br /> 0 15. Special Handling Ins fiom and Additional Information <br /> Z HANDLERS BE 40 HOUR OSHA/SARA TRAINED 3 ° $i9 - <br /> w AND USE NIOSH APPROVED PPE. <br /> EDICT OMACTs 916 371-5747 <br /> J 16. GENERATOR'S CERTIFICATION: I bereby declare that the contents of this consignment aro Fully and accurotelY described above by proper shipping name and aro classified,packed, <br /> UQ marked,and labeled,and ore in all respects in proper condition for transport by highway according to app licable International and national government regulations. <br /> J IF I am a Jorge quantity generator,I certify tel I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economica11 <br /> Hpracticable and that I have selected the rocticable meted of treatment,storage,or disposal currently available to me which minimizes the present and futon thresh to human health <br /> and the environment;OR,if I am a small quantity generator,1 have made a good faith effort to minimize my waste generation and select to best waste management method that is <br /> 0 available tome and tat I can afford. <br /> } Pr/ir�•ted/Typed Name Sighw ra - - Month Day Year <br /> Z `^C <br /> w T 7. Trans rear I Ackncwl rent of ecei t of M serials <br /> w j Printed/Typed No Si <br /> W P <br /> O1-it Trans rter 2 Acknowleclement of Receipt of Materials <br /> I Printed/Typed Name - Signature - Month Dvy Year <br /> w [ <br /> Q R <br /> k ." 19. Discrepancy Indication Space <br /> F <br /> PZ A <br /> C <br /> 1 <br /> L <br /> 1 20. Focili Owner ar O rotor Certification of receipt of hazardous materials covered this m6ni(est except as noted in Item 19. <br /> T Printad/Typad Nama ^yam, Signature Month Day �y,•ar <br /> Y <br /> DO NOT WRITE BELOW THIS LINE.' <br /> a - - - - - Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. <br /> DISC 8022A(4/971 (Generators who submit hazardous waste for transport out-of-state, <br /> EPA 8700-22 produce completed copy of this copy and sand to DTSC within 30 days.) <br />