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Stale of California—Environmental Protection Agency Form Approved OMB No.2050-0039(Expires 9.30-991 See Instructions on back of 998 b. Department of Toxic Substances Control Please print or type. Form designed for use on afire 112-pits rifer. Sacramento,California 1. Generator's UB EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areae UNIFORM HAZARDOUS is not required by Federal law. WASTE MANIFEST a t- of f r 3E" b6 1 I 3. Generator's Name and Moiling Address ''tip +[hr; `,,,,Y a ', (. Colt 14Q A. State ManlFert Documeet Number y O w V„ F .it TMtECH 20303 o La}�� iI. , ��gp, T$�[IL"ya y ry 4�;�? ,, B. srote Generator's ID h A. Generator's Phone ( ;.^ y1 83Z-5w Ito EN: k.Ah Iki.CA`IK”5. Transporter 1 Company Nome ^� 13 T n c'tl 6. US EPA ID Number C. Store Tranaparter's ID[N eserve ] h aD [• i D. Transporter's Phone ,kstf 16 y 3M, 26 t o .,NFETY-idL.EE:kS TEF# 1w 7. T,.o porfer 2 Company Name 8. US EPA ID Number E. Smle Transporter'!ID[ rved.] W4� is t:Ii'.FIF9fld�lk:.4!'Tiit k8 M kTt 4n on* 'tY G ''� ' F. Transporler's Phone s`{Iw: '.. SIG N9. Desi noted Facility Name and Site Address 0 US AID er G. Sta a Fasiliy's ID z �E7 r 1tl Ll ow r at+�a _�-.,� .1 1pp AN&N I)TE n7G. QZIIiNV Fwo Is r�('LAli ) ;T H. cites Pone 10 04"1 evsk MillIL-itW 12. Containers 13. Total 14. Unit Q V 11' . US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No. T Pe Quantity Wt/Vol I. West.Number • , State "7' 3 �= a((�CETZNt TOLUtWC , UA114431 " 7 3 GFaT' �nhibf� IENj I i, U,Jlr�k/? t 3Z FF15 the. .3 6. $ataOEEEP th3,51 n� 1 5 P oT t n7�/c State -33 m O 7.2 1 U N 7 1 f D A/Otte r W d. U!I L r..FrF.. , , u 1. stare / �1 zTl p /' �a f. n EPAfQIbt[ v u4 y1 � r K. Handling CddaR For Wasfn Liited A6ova Z J. Additiosarl DrsFG s + 7"i WY9v� Il+�d pO< 1 a b. 2 sIRll2lz. L at ply `y,S.DP ILc:2d2a I l IY' �� d. ttrii � � G`td ( fYfl � Z 15. Special Handling Instructions and Additional Information „ • I L 'y' 9 6 &XL. .i—£ &A s 4SL`'ab- �?d�—A ?60 t :h4 ;N �;a w°Ste 3t ifFM3 ai T a3�L Oti AV 9 p*TkCT IVE CE . I z IA11 E1�4Et3tEl Wt' i 6UJV. .ta ,v Nr3SlttEPP-* "dt^ 9 3IEa�jq / IL� R /'!) alrE� i Job* 16. GENERATOR'$ CERTIFICATION: I hereby declare Ilial the contents of This consignment are fully and accurate)y daxri6te above by proper shipping name and are classified,packed, "U marked,and 1o6e1ed,and are in all respects in proper condition for transport by highway according to applicable imarnalional and national government regulalfoTs. If I am a large quantity generator, certify that I have a pro in place to reduce the volume and toxicity of waste generated to the degree I have determined to 6e economica11 ii practicable and that)have selected the practicable method of trea".N,storage,or disposal currently available to me which minimizes the present and future threat to human health N and the environment,OR if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is C' available to me and that I can afford. Oe Month Day Year y Printed/Typed Name 1, Z / 1) ,' tfw4l ,.lawiG moi:`,' T 17. Transporter 1 Acknowledgement of Receipt of Materials ASignage �1ont DaY Yeor Pri d/T ed Name uG7 1 S L35F A - S01 M?o W P _ W 18. Transporter 2 Acknowledgement of Rise t of Materials Month Day Year 0 T Printed/Typed Name SignaNm i N E 1 A I 19. Discrepancy Indication Space Z 20, Focili Owner or O eraror Certification of r.cei t of hazardous materials covered b this manifest exca t os noted in Item 19. T Printed/Typed Name Signature Month Day Year Y DO NOT WRITE BELOW THIS LINE. DTSC 8022A(1/991 Yellow: .GENERATOR RETAINS 4 EPA 8700-22 1