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Sroh of Californip—,Fvironmahrol Protection Agency 4 <br /> Farm Apryved OMB No,2050-0039fExpires 9-30A9I �d j See Instructions on back �9e b. Department of ionic Substances Control <br /> wrih <br /> Please prRv or type, fOw#Vmi fired for we on elite(11-pifc eSacramento.California <br /> 1. Generator's US.EPA ID No. Manifest Document No. 2. Pogo I InFormafion in the shaded areas <br /> r UNIFORM HAZARDOUS 6 nor rega6ed by F der I I w. <br /> WASTE MANIFEST 31. ti op T <br /> 3. Generator's Nacos and Mailing Address A''Sfoh Manifest Document Number <br /> HEWAM SIERRA PAPn CCaPANY <br /> O B: Slots Generator's ID <br /> W) sea :a. c+v�0� STT , STC=, Y, CA 95203 <br /> A. Generator's Phone I „� I / <br /> r S. Transporter 1 Company Nome 6. US EPA 10 Number !C. State Transporhs s ID - t <br /> h <br /> O '0 C ('s • +77 .m iv _ l D. Transporter's Phone <br /> m 17 n / T - <br /> 7. Tranep.",2 Company Name 8. US EPA ID Number E. Stole Transporter's ID _ <br /> 4 F. Transparkr's Phone <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State F.6lih/f ID <br /> Z ENSCO WEST, 1,4C. ( 1,41,dj'F <br /> 1737 EAST -MCNT. 'J1rT41.NGMN, CA 90744 1 H. Fac 'f Phone <br /> A a <br /> �...CJ <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Container 7 3. Tocol 14. U t - <br /> P li 9 P PP'^9 No. Type Omntiy Wf/`/ i I Waste.Number <br /> °' State <br /> NUI—IM, -r',AZAMEOi:S WASTZ SOiTD <br /> 3 G Ly SOLI-I S) '1ALRG954171 EPAfOlher <br /> G t' <br /> -X[A <br /> o scot. <br /> m E <br /> e R <br /> EPA/Other <br /> v A <br /> o T `' State =y: <br /> m O <br /> R EPA/Other <br /> s <br /> w d. <br /> � Stale . i�� <br /> Z ' <br /> V EPA/0t6ei- �.. stv� <br /> Z1 Additian.LD ptrans fa Mal Is Listed Above - K. Handling Codes I.,Wastes Listed Above <br /> r <br /> w z <br /> OeCai. nalingmvruc- na?aalli nasion ; <br /> '4A:CLERS BE 40 iiOUR CSIIAJSA W RAIN2D <br /> Z <br /> w A11D USE 31C;SH APPROVED PPE. <br /> B9213MY LONTAM 916 371-5747 <br /> 16. GENERATOR'S CERTIFICATION: 1 hereby declare that the contents of thisconsignment are fully and accurately described abovoby proper shipping name and are classified,packed, <br /> `t marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> V <br /> -'' If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste geneiated to the degree I have determined to be economically <br /> Npmclicobla and that have selected Ina practicable method of treatment,storage,ar disposal currently available m me which minimizes th"asent and furore threat ro human health <br /> and the environment;OR,IF I am o small quantity generator,I have made a good faith effort ro minimize my waste generation and selwrth best waste management method that is <br /> Oavailable to me and that I can afford. - v <br /> } Printed/Typed Name Signature Month_ Day Year <br /> w R 17. Transporter I Acknowledcement of Receipt of Materials .t <br /> A Printed/T ed Name Si noturen Month D Year <br /> R i YP (v'4 (.r 1�, g .� w <br /> WP �-� .may— >., 'Tt }r's- - t "1 . :. <br /> w 0 I8. Transoorta 2 Acknowled ement of Receipt of Mmedals <br /> O T Prinled/Typed Name Signahre M711, Day Year <br /> w E <br /> Q R <br /> V 19. Discrapanrylndication Space <br /> Z F <br /> _ p <br /> C <br /> 1 20. Facility Owner or Operator Certification of reaei t of hazardous materials covered by this manifest except—as noted in Item 19. <br /> T Printed/Typad Name Signature - Mondt Day Year <br /> Y <br /> DO NOT WRITE BELOW TH LINE. <br /> DTSC 8022A 1d/971 <br /> EPA 8700-22 - Green: TRANSPORTER RETAINS <br />