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Aua , 14, 2008 3 : 13PM Fairmont Sian Co •/Lodi ,Ca • No •4122 P . 2/5 <br /> �` <br /> Please INinCr�(l�pe. form designed far use on elite(12-ditc. awfifer� ,- . Pwm Approved.OMB No.2950»039 <br /> UNIFORM HAZARDOUS t. AB1aA�J ID,Wmha 2 Page 1 d 3,Eme71gerq Rea9oroe Phone n(est TrrackingNum6n n <br /> WASTE MANIFEST ` <�1..0 u „�! 0002 <br /> 304701 F L E <br /> iQ <br /> $.Denaanr'9 Name std Madhg A1area Wa Sqe Address;(tradedent ow mating addRS31 <br /> ,r ICKri <br /> Creneraeiy5 Pt9nE <br /> angpod9l U.S,EPA ID Number <br /> InnAlceSt in, <br /> f' T =-, <br /> 7.'R9spdrter2 Company Nage U.S.EPA ID Number <br /> • <br /> 8. soNy Name and 9EiAddreas <br /> t@pXr,`44-,Wier Sank.I?-59 I U.S.EpA1D NYMa <br /> 9a. 9b.U.S.DDT Description(mdudng Prod,ShiMng Name.Mewl Clens,ID Numb, 10.Conte 11.Tafel d <br /> HM and Paddg Greep(d s5')) No. Type Quemoy 12.12.UnUn 13.Wane Cada <br /> 1. <br /> G aA'f,l"r:Ct.^Fc .t M.�AT��(AI "rAIIJT A( '^_`fr�y�E): <br /> � x' liui <br /> (rQo 3, T)( 00l 11t !'Gqno f <br /> W <br /> r� <br /> I <br /> ter.Soedei Nandang dradrKtba and A00ltie71al Inbrma6m <br /> S -,L e,,ei yl �2Z(i <br /> 15. GENERATDR'SMHRWS DEFi1RCAT10Nt I hereby daa9e Cat Da oon(eat•8ds ootdow mentae by and 8mm"deeWhed®Save by Ne p,pparai"narne,and aro dawIted,pMgW. <br /> marked 9711 4baledfplarnrd.d,and are In al mW a sI In props cond8bn for transport aax FdN W aDWSrable lmemato al and national <br /> gwwnmardEo)orta,109"that the wntans Mthia mrmignm¢nt conform to aw tame of 7e abased EPA • .If export shipment and I am ft Pnmvy <br /> Pa1mo. nofCalsat <br /> Imrlyy Uet Nwaste miNMzaad713alxremldenGfied'n 40 CFR 28227(a)(Yl amalape Wanah9d�roemlor)or(6)(ul ameama'l9uanM1tY 9en��J'a We. <br /> c 3 tnv <br /> 1pd mar <br /> "CA <br /> slaprnents / �yrr4 at o- <br /> id.lntemapaky , <br /> ❑lmpodm U.S. LJ Export fnfn U.S. P9taferylaa2 <br /> -Lwnporter won fur <br /> W halal 17.'rWrowsrA�aMeco entofRacepto(Mated. U.S,: <br /> � Tran 1 Pnn N9ne sue <br /> CL <br /> Tranapgter2 PrinfedRyped Nare <br /> ♦ 19.Diesepancy <br /> III 1Sa.Discrepancy Mdicadon spar» �.:.s_ <br /> ❑ Qu.nBly ❑Type ❑Residue ❑ParBal Rpm ❑ REjaAo <br /> ectiFuN n <br /> f 1Nf.Al w Faafly(a Generemfj MafrfaA Relemnce Nanhet' <br /> � B�fr t'r:3t'[s�"a•+3S LT:B'dbAf'3G(i?P?j ne+Trt'3 TDf'3?Sd 4RI1 i::-aRpT',fA Ne U.S.EPAm Nunbe <br /> V <br /> QF 3 Phone: dSCE EI1s oenerator is 55119yNy)r <br /> 4W 78c.5igrcaay9 aAaemate Fad6Yy)a <br /> Y <br /> Mmp71 on Yea( <br /> O19.NaZandoue Was»Repan Marep9rera Method Coes(.e.,odes Por ham71do,4 waste b shrpt depo%9,and recony.yams). <br /> 1U1 1 4. <br /> ZD.Designated Fai.y PAfara 17paaar.Ceraflcatcn pfnxepl of harardats malsials cued by the menaest exfept a rated in gem 182 <br /> ?7Nx'•TYPed Nerra .5gnaael. htelldl LTORar <br /> EPA Faro 8700-22(Rev,3-15) Previous eadDns are obsolete. FACILITY TO <br />