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Jun 01 04 06: 20a NEWARK SIERRA PAPERBOARD 209 464 9215 P. 10 <br /> Slate of California—Enwmnmanfal Protection Agency � <br /> Form Approved Oydl No.2050-0039(Fepims 9-30-991 - Sea:InstrU<tions On bOek OF 11090 6. Da <br /> Please prSnt or typs: Form deaiydei/'for effh f 12-pihdl HP.wnhq .. _ partment of Tonic 5v6stoncm Control <br /> Sacramento,California <br /> 2jO5e,(—A. <br /> NIFORM HAZARDOUS 1. Gena afo/s US EPA ID No. Manifest O-.emml Na, 2. Page I nfrrmafion in the shaded areas <br /> WASTE MANIFEST ({ 4 I is at required by Fed I., <br /> d of t <br /> Generator's Name and Moiling AddressDocument N'rnber ,ry <br /> lc Sierra SiteAddOress' $,J . <br /> c . 'burch street _. SAME <br /> AUGq V <br /> RrrLtor%�P'rPm gP3�Y Tfk? 'II .. G O4 2W3 w.36p'�'ep is 1D <br /> mp°rter 1 Company NameU3 EPA ID Number Hari3urs treee�ices EfTc 4 0 3 9 3 u4dPrref°4sporter 2 Comprny Name - 8. U:iEPA ID Number 4..5-•v.R el..,w. D G. �L 1 `� �la7.vignated Faciliy Name and$ih Address 10. U5 EPA ID Number OuSW Fq Ili rberg San Jose LLCefrya.;E3 Road0 se,Cti,9343:T v O 0 5 9 G i3 1 <br /> 11. USDOT Description(including Proper Shipping Name,Hazard Class,and ID Number! 12 Containers I3. tom I A. Lnio <br /> Z ( No. T e oecmlq w1/v 1 Iw Ie.V moa: <br /> C �.f.3a�y ��+lr�srba.E•sGa. r3o�J Pc.3�1 qq �r T] <br /> 3 E V t i. 004 <br /> oCo <br /> N 44L11!42=,:22ra •tat'"+`cGOUS V ASTEE UQU;DS ,NONE,NOW: - <br /> v e It AJOA) Tee.6 Doerr-'c=r.R.t•C. Ort S <br /> A 'EPA,, <br /> T <br /> — <br /> R EaA/om�r <br /> m <br /> z <br /> z slate <br /> w <br /> V <br /> .w vA/olhed <br /> Z- 8���tsA'Ir�t;.;1,L'•O�n9 } Alio f� 'a' � '.`�fe A� Y�'� x��"���* 41��d�•''-��Cs�+,s"'tl .19,at7 10�.G'oBes fRr,,Nrmled ls*ted:A IrY .: <br /> - <br /> h <br /> Of <br /> Z : ,'. ,, .M r.t^„�. hYa. 4 iit"1 �, 3r�v�w•-n„^;e•x%`_^t1r„r;.€ '' <br /> o s.arSpFf' r i liefn Grit T °g�as�e`��a GN40479 116:CH40476 FC19455At4 <br /> z <br /> w <br /> x <br /> Q16. GENERATOR'S CERTIFICATION: Ihere6y d.darq that lha<onhnh ofthir d°nug utero Fully and anU—ftly dvsrl6eda6ow6yprapershipp Og name and era daved,packed, <br /> V marked,and labeled,and are in all respects in proper condition far tram Part by highway according to applicable inhmafional and nalianal government regulations. <br /> IFI..a large quanti generator,I carfify that I have a propmm In plae to reduce the volume and Ivziciy of w°sle generated h the degree I have determined to 6e economicallyy <br /> OL <br /> practicable and that I how selected theruetieable method of treatment,storage,or disposal currently.0.61.h me wbich minlmlzes the present and Future throwt°human 6.11Kw and the environment;OR,if I am a small quantity generator,I have made a good faith'effort to minimize my wash generation and select e best wrote management method that is <br /> O availabl.N me and that I Can afF.,d. <br /> y Pr' ted/Typad NaP QbA s <br /> V e'TA L 51gn uwf Month Day Year <br /> Z c+[/ert Vl Q'Js7h .Y� t!) r'; 1.y. <br /> w R 17. Trona arhlr1 Ackn.w6d emeet of Receiptd Materials <br /> ymj A Prinhd/Typed Namv Sgvam rMonth -y Day Year <br /> E. p�l\ rGl• �.•k�.i6�t061`e C <br /> w P <br /> w 8 I8. Trans erhr 2 Acknowlvd emenl of Reuss 1 of Mafsitlls ✓ <br /> T Ninled/Typed Nome S. n.N. <br /> w E 9 —�} .:�.tonfh, Day.. Yeor...' <br /> a R MIRE <br /> V 19. Discropanry Indication Space <br /> Z F <br /> — A <br /> C <br /> I <br /> E <br /> 20. Facility Owner or Operator Certification of receipt OF hazardoat mahriab wverd 6 8sis manifest a....t—noted In Ile.19. <br /> YPjpf�d/Typed Name !1 / Slgaat } Y ,r-Month Day Year "i <br /> �.. + it <br /> DO NOT WRITE BELOW THIS LINE. <br /> Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. <br /> DTSC 8022A(1/99) (Generators who submit hazardous waste For transport out-of-state, <br /> EPA 8700-22 produce complaW copy of this copy and send to DTSC within 30 days.) <br />