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Jun 01 04 06: 22a NEWARK SIERRA PAPERBOARD 209 464 9215 p. 12 <br /> 05/27/04 07:213 r%AA 17076444 Y15'1'KV UHL1111 <br /> ?�+1�'$rp�teL'Eornio-+Envirarnnanaol Proleciian Ag®ry <br /> Frirm•4pravad OMB No.2050-0039;6pires 9-3fk961 Sea Instru4chonsi an back of stage b, r. <br /> Please print or". Farm deo yg d For via an 44*f r2trr1�1 writer, <br /> -\ 4'pe r Prpartmertt of Tawir�wh,tanear Centra <br /> Sacrnmrnm,Califemla <br /> UUNlFORM HAIARDOUS 7, Genetoior's US EPA ID No, Manifest Document lJa. 2. Page} Infarmation In the shaded stoat <br /> WASTE MANIFEST 7 1 1 5 7 7 w 7 is nat tegvirad by Faderol law. <br /> f � 1 of I <br /> T3. Ganeroior's NName andMa11inQAddress <br /> f37+ 4d1Tl�r1l tt?I 1i..: r� <br /> Ln <br /> a <br /> `:r <br /> Ln 4. Generator's Phone r - ,� <br /> 466--70 8 X _5y <br /> O 5. Transporter f Company Nome 6. L FpA to Mmber ' <br /> Petrochem Insulsti,3ne Inc. , <br /> jLAL ,) t102 " 1412 .5 <br /> m <br /> 7. Transpater 2 Company Nae 1 -.y <br /> U - <br /> 8. LIS EPA ID Number <br /> aced Pacll <br /> �- Daslgn „Y hlome and Sirs Addresf 10, LIS EPA ID hiumbrr - <br /> %�H L.And ill + :1 <br /> w-42b :lair Road <br /> ti- •V.-caville 0A 956331 P. Df 101812 {1 2 7 5 <br /> Z 11. US DOT Deieriptian[Including proper SWIPPing Name,Hazard Gass,and to Number) 12, Gnntain,, 13. Trial 1 IA. (lett <br /> LOa Na. 'T tr^aanti+y Wr/vol 3> <br /> R.e::t_, Asbestos, 9, :HA2213, PC;TTI <br /> 4 <br /> E <br /> m N b. <br /> N <br /> �t R - :u <br /> A z <br /> m .T C. <br /> i <br /> R <br /> LIU <br /> d. <br /> L.t - <br /> w <br /> - <br /> � +�, .�4 X '"�y'z «r'r " .yr F � a� r •xlv �� .� <br /> C3 <br /> 15.Special hCarrdtirrq krsUt`clforss and Additional ktformatien - ,t <br /> Wear apkrgved respiratoy equiPattent End protective Wlothil3j;Ul i <br /> !-*cal .APCOt Scan Joaquin Air Aunlity <br /> ,,,mer3ency Xur-g1xer: 707-644-7455 Job #8733 <br /> "t T6. GIENRATOR'S Cr>RTIFFG4TION_ I hort6y ded ra-rhat the rnraenh a{this care] <br /> gmnans tied fully and acelxdefy described above 6y proper shipping name and aro claim ted, <br /> V packed,marked,and labeled,and an 1n aN rospects in prapereendPl{ers fop trtestpad by highatay attadkw b aRVI'rcable fMemohvnal arrd nariongl uovemment npulaitwne_ <br /> if I am a Irige qudnh-fy gerrarafor,1 certify that I kerne a program yin pia w to reduce the vohwne and toxicity of wasto pcnatoled to the dayrae I frava daiarmined to be <br /> iy <br /> economically practicable and that 1 have selaRed tfla procdra6}e,miLfhod of steatgtera,staapa,or disposal currently avddable to me whichroan mminimizas the present and{otwe. <br /> Q <br /> u} threat to human health and the environments OR,it 1 am a smell errgnh'fy generaAor,I have made a geed forth effort b rrrinimin m wsta ethod that is ovoikoble to rtna--d that I Y wvstd se <br /> e generation and the 6cat <br /> Printed1Typed Nm <br /> eo. can afl;xd. <br /> // Signature <br /> �'r"7` .�r�l€`'I c:i .��'',/.� rid / •- MorAh. Day Year <br /> 7. <br /> tau R 17. Trons i Ac'bnawle mart of it" t of Material, � <br /> (y II Pr n yped Nomeslgtiakne. r - Monti, n r <br /> ecw s \ \, ay <br /> W B It. Tram .2 Ackno'%if nt of Arte of Materiab <br /> ser- T ➢tinted/Typed Nana -- <br /> Q 1Month Day Year <br /> N I 19. Discrepancy Indication Spot* <br /> a F <br /> V A n <br /> Z C <br /> 120. Facility or r C .I kot>•an al raev dol hazard..matcrlals covered 6 '(manikst woo as rte n Item 14 <br /> * Printed/Typed t�am� I r <br /> aprtaRt�re.�f `.•' r �°nr6 D ;r, <br /> DO NOT W 1'E BELOW I NIS LIVE. <br /> OTSC 4022A (7/95) <br /> EPA 870u-22 Groan, TRANSPORTER RETAINS <br />