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Slate of California—Environmental Protection Agency f—I E` Form Approved OMB No.2050-0039(Expires 9-30.99) See Instructions on back of page 6. Department of toxic Substances Control Please print or type. Form designed for use on elite 02-Pi fchl 'iter. Sacramento,California UNIFORM HAZARDOUS enoner s US EPA ID No. Manifest Document N 2. Page 1 Information in the shaded areas LAI`i`83b,, 5;v': i is not required by Federal law. 3687240 WASTE MANIFEST of v Gel grata's Name and Mallin Address •"- A. State Manifest Document Number ...3a. 1-1 Aamu r I.silinpA s(Jr A T TN ROGER '...0 L)I Ctr 95240 B. Slate Generator's ID A. Generator's Phone ( 209) 333-68-20 n 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID[Reserved.) C? T ETY-i J_EE:N. SY iTEME,', I NIC T'XR0000509311 D. Transporter's Phone 7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID[Reserved.) L(}Q F. Transporter's Phone B_ t F I'ty�,t n t ,pfd 10. US EPA ID Number G. State Facilit 's ID Na 6000 88TIJ STREF. T SACRAMENTO C:A 951322 CACJGO+j`)8y` i '- H. Facility's Phone w ;..0 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Containers 13. Total 14. Unit No. Type Quantity Wt/Vol I. Waste Number L�rfZ a. HAZAT�1)0 , WAC'Tr-, LIOU IDsN. C.1. `i ),1)-. i State _ NA3082 PG % SS fD039 F} PG#I—II - 3 G Ai�UEFJU i BRAKE SLiLUT1ONi8. '4l A`L, i � EPA/oyer PKJ' E o N b. f State ro E R EPA/Other v A State o T co RR OCT 5 2005 EPA/Other d. LO State �LO w CITY OF DI EPA/Other V MUNICIPAL SEFMCE CBM w J. Additional Descriptions kr Materials Listed Above t K. nanoYing cows fie - a b. d. Z r : •.•:.!W c,l s 4.n... [;�. t. sav 15. Special Handling Instructions and Additional Information Q ?C.ENC;E.Lf EiUr4Gr.0, i:E t�)-r C.A p R IEfT, 'L, Nd CESSAR'(. Z x 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and acc.nshuy described above by proper shipping name and are classified,packed, Umarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. JIF I am o large quonliy generator,I certify that 1 have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economical]y d practicable and that I have selected the p racticable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health N and the envi ton menta if am a small quantify generator, have made a good faith effort to minimize my waste generation and select the bast waste management method that is Of O vailable to and that at I<an afFo:d. Z Printed/Typed Name I Signal nA Monl Day Year i 1 i ` Q U o W a T17. Yrans o t m 1 Acknowled eent of Receipt of a rials A P 'ted/Typed N me �„ 3 gnatur -— Mo Da Year I_C 16 Is 16 - 12 ILI LL a 18. Transporter 2 Acknowled ement of ecei t ofMaterials T Printed/Typed Name Signature Month Day Year w E Q R V 19. Discrepancy Indication Space Z F ' — p C � t ( 0. Facility Owner or O erator Ce ification of eecei t of azardm materials covered b this manifest.except as rimed in Item 19. T Fri tjd/�Ty / ! -��' S,nature -- 1 I Do Yagc.� VA 60 NOT WRITE\B W S Lf(JFy�_ Yellow: TSDF SENDS THIS COPY TO:GENERATOR WITHIN 30 DAYS 22A(1/991 (Generators who submit hazardous waste for transport out-of-state, DTSC 80 EPA 87022A produce completed copy of this copy and and to DTSC within 30 Joys.)