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' Stab o al. vir emt.ct on Agency - - <br /> farm 39 IExpxe 930-991 See IJ15tTUC}lons On back of 'Qe�. Departnent of T6xic Substances Corr, <br /> j}pD ",California <br /> Pf.ass�J o mh@sign kr s.on dire(lap• 1 "riteE" - Sdcram <br /> UNIFORM HAZARDOUS ro:s US EPA ID No. Manihst Dackmi*.411 j 1 y 2. Page} Information in is not required by Federal law. <br /> he:h6dMla ea <br /> WASTE MANffEST ar T1 3T.loin loll It 11 loll I of <br /> 3. Generate Name and Mailing Address 'v <br /> U:S. RENTALS <br /> ' 2081E CHARTER WAY, STOCKTON, CA 95205 <br /> n41. Generator's Phan.12()q ) t s I <br /> N 5..Transporter I Company Nam. 6. US EPA ID Number lransporte(s ID <br /> h _ <br /> � n pouter's Phone <br /> RAMQR F.NVTR0NMPNTAT. qp.RvTrp-q 1A In lo 1& 14 lo In h 15 1,; 16 <br /> .371-5747 <br /> m• 7. Transporter 2 Company Name 8. U3 EPA ID Number - E'Sote Trbnsporte(s ID t. - T <br /> f. Tmmporter's Phare — <br /> Q <br /> V 9. Designated Facility Name and Site Address 10. US EPA ID Number `,t51pse Facility's ID '. <br /> CHEMICAL WASTE MANAGEMENT, INC. `� ll <br /> 35251 OLD SKYLINE ROAD, KET1 NIAN CITY, CA 93239 h'FP <br /> d� ATOO � b 461 1 7 1 <br /> LCA 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number ' 12. Containers 13. Total 14. Unit <br /> p (� ng M PP" B ) <br /> No I Type Quantity WI/Yol este Nu be <br /> 41crZ a. - 'le <br /> fes? N")N-ICRA HAZARDOUS WASTE SOLID 23 <br /> �3 G (OILY SOLIDS) NAERG96$171 /other <br /> N <br /> E b. <br /> o N <br /> erne E <br /> a R other_. <br /> a A a <br /> o T <br /> 03 O <br /> R YOther. <br /> e <br /> r d <br /> Z <br /> tss /Od,er <br /> V <br /> Z <br /> to O <br /> W <br /> d <br /> 0 15. Spacial Handling Instructions and Additional Information <br /> HANDLERS BE 40 HOUR OSTIA/SARA TRAINED <br /> W AND USE NIOSH APPROVED PPE. <br /> IIffiNICY ACT: 916 371-5747 <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the consents of this consignment era fully and aceurate)Y described above by proper shipping name and are classified,packed, <br /> marked,and labeled,and are in all respects in proper condition far transport by highway according to applicable international and notionafgovernesent regulations. <br /> If I am a large quomity generaroq I ceMfy that have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to economical <br /> i practicable and that I hhave selected the practicable method o treatment,storage,or disposal currently available to me which minimizes the present ansJ future threat to human healM <br /> Ott <br /> 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 wash management method that is <br /> O available to as.and that I can Mord. <br /> �. <br /> y <br /> Printed Typed Name Sign re Month ,Day Year <br /> Z c <br /> T 17. Trans r 1 Acknowled ,mart of Ractn t of Materiels ' <br /> Kj Printed/Typed Nam. Signature Mantle Day Year <br /> W 0. _— <br /> W P <br /> W F 18. Trona near 2 Ack emenl of Receipt of Materials <br /> 1 Printed/Typed Nome Signature; Month Day Year <br /> w E <br /> let 'R <br /> V19. Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> I <br /> k <br /> 1 20. Facility0weencrO ratan C.Mficofion of recce t of hozardoas material.covered by this manifest exceptos noted in Item 19. <br /> 7 Printed/Typed Nams Signature Monll� Day Year <br /> _ z,tc 3 <br /> DO NOT WRITE BELOW THIS LINE. <br /> Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. <br /> DTSC+8022A(d/97) (Generators who submit hazordous waste ser transport out-oF-stale, <br /> EPA 8700-22 produce completed copy of this copy and send to DTSC within 30 days.) <br />