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N%, A ARDOU.S-WASTE MANIF-.. S., <br /> Please print of type .< (Farm designed for use on elite 02 pitch)typewriter). - _ - _- <br /> ' Maniiest."-, 2.Page-1 <br /> NON-HAZARDOUS 1,Generators EPA ID No Document No.' <br /> WASTE MANIFEST CAD. 932 5=18 251 of <br /> '�3.Generatoi``Name arid Mailing Address <br /> :nified .t11�St 1 GXOC�rs. At-tR: Tl�t <br /> 57_00 Shd.i1a Street, •0:)INbeM9,, CA. 9004 = <br /> 4:Generators Phone( ��. ..264--520 -- ._. - - - - <br /> 6. 'US EPA ID Number. - A.State Transporter'siD <br /> 5.Transporter,t,Company Name.' - .. .. - - r <br /> - -080 - 8.Transporter 1 Phone — — <br /> c3z Mat-Tt"1s Tmc� <br /> .. 7,.Transponer 2.Company Name <br /> g 2'.US EPA ID Number G.State Transporters Ib <br /> - D..Transporter.2 Phone <br /> 9.Designated Facility Name and Site Address - Y0: _US EPA ID Number `-E.State Facility'3 ItT <br /> rOY�1 <br /> F:Facility's Phone. , <br /> 2 E <br /> :y.. f•e <br /> .12 Containers =13 <br /> - .74. <br /> I 17 WASTE OESCRIPTION - - - Unit <br /> No '7yPe - W <br /> t.Nol <br /> t <br /> r1l-�S <br /> G <br /> E ; <br /> : E _ <br /> V R, G. <br /> T <br /> FEandling Codes for Wastes Lrstsd Above ' <br /> .G,Addiliondi DescripnoMs,tor Matenais Listed Above - - - <br /> ' a.} ns -;�azax3ous. grater <br /> j 1tOFIL� '-01-06 <br /> 15 Special Handling instructions and Additional lnformalion - JOb Site Stud} ton„ 'r cility <br /> S Stockton, 95215 <br /> Y6:.GENERATOA'S OERTIFICATfON:I-hereby certify Shat the conienls:oI this shipment are f i y and accuratolq descritied_and are'm all respells - - <br /> - irk propel'condition lortraosport,The;matenals described on this manitest'are not subject to federal hazarclous waste;regulations ; <br /> :Date' <br /> Sgnalure, 4lorrih ' Oa�'.:Year-. - ' <br /> Printed/Typed <br /> - - � Oate' - • <br /> 17.Transporter 7 Acknowledgement of Receipt ct Materials - Year ' <br /> R Sign r t <br /> t1 1 /'r <br /> S L �'" Date ' <br /> p' <br /> Q 1 B Transporter 2 Acknowla' ement of Repeipi o1 Materials -,-- <br /> H Signature <br /> _ Month, Day Year <br /> T- Printedrryped Name <br /> R <br /> .:. 19.`DiscrePancy Indication.SPace - <br /> A <br /> C <br /> 20 Facility Owner or Operator;Certification of race+pt a!the waste snatedals covered by Ihis manifest ezLept as noted in item 19 <br /> .. $ignaturE r Month' Day ".Year- - <br /> '.T ..•PAntadlTyped Name -,,.' -,.:• _ - <br /> ® 8p0 (jQ1•$808 yryNw.Wistmasler,.com pRMMOHRECYCLEDPirPER Tomow -'Rev 3195 _ <br /> F-1402002,V'-LJ�AF3l`:I�STFR..[ ) . ,. .. _�� rlSiNG SOYrrFAN rcM <br />