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state of CaAbnio—Enrirenmwrol P,cmd.on A,., <br /> FormAppeared OMB No.M50-0039(E.pires 93099) See Instructions on back of page 6. Deparensrtt of Task Substances Central <br /> neav print or yen. Form ams,gn•d for use on slim It 2 piIch/ypewdfer. <br /> Sacramento,Gahkmia <br /> AL UNIFORM HAZARDOUS I. Generator's US EPA ID No. Mani{est_pocumem No. 2. Page I lebomation in rhe ahodsd o.ws <br /> 1 <br /> WASTE MANIFEST �CI rwaired by F.deral law <br /> 1,` I i , a <br /> 3. G•n•zarse,Nome and Muslin,Address .yT 1 �� i _j A. Stab Mscif.0 Document Number 23789813 <br /> .SA+ <br /> U �ieF'ty <br /> I B. State Generomd>ID <br /> A. Gro•rowr's <br /> r 5. transpose.1 Company Name 6. US EPA ID Number G Stam iransparters r0[R rwd,1 <br /> h <br /> s0 bo AMF 1^A.1.VALLEY WASTE lii f; A t-1 <br /> '2 eTrwspono.'1 phone !Ps-7 <br /> - <br /> m 7. Tromporter 2 Company Name 8. US EPA 10 Number E. State Transporm:s ID(Re__rredl <br /> I I I I I I F. Tronsporter',Phone <br /> 4S 'NK*RdA'f* 7Itaf�{A"", 0. Us EPA ID Number G. srm a y' ID <br /> J O iS I is <br /> )z 5."CLAUS ROALBH Fa<eiy,Phone L----- <br /> )O RIVERBANK, CA 983367Cr AlLl 010101 119 1 6. 206.86:3 d31 SIT <br /> ea l I. US DOi Des<.iptian lindudng P.oPer Shipping Name,Hazard Class,and ID NumMrl I2, Containers 13 Total I A. Unit <br /> �V Np - <br /> , Tye Ousnn WI/Val k-Waste Number <br /> J= NON-RCRA HAZARDOUS WASTE LIQUID ate 2:3 <br /> LILY WAT LR C3 ..#PA/Otho, <br /> 3 <br /> E 6. '., re <br /> m N Sto <br /> m E --- <br /> a R <br /> EPA/Olbar <br /> v A — <br /> T -«nn <br /> m O <br /> _ R =PAlo�n.r <br /> Stora <br /> Z <br /> w EPA/Other <br /> V { <br /> w' f <br /> Z i 1, Additional Descippws for materials fisted Ab. K. Haadhng Codes tar Wasms lured Above <br /> 2 OILY WATER tyl b, <br /> ars <br /> sm -i <br /> 4 <br /> 0 15 Specol Handling Instructions and Additional Information <br /> z <br /> `a GLOVEN <br /> Z EMERGENCY PHONE 209,567438.57 <br /> = I <br /> r_ <br /> J le. GENERATOR'S CEETIFICATIaN: (hereby d«Icon rhos the crosann of this consienmanran Fall,and occuraMy described a bate by Proper ship ing name and u.classified,Pocked, <br /> VQ marked and kb•led,and an in all respects to proper condition for osnspon M'highway according w aPFd able inremananal and nm�ona�gawmmenneg„tatiens. <br /> J If I ora a longs q—Ii gsnararor,I cufify char I hare a progr in Place to reduce the+alum.and ro.io.,of was,.generated ro be degree I h...determined s,be«enami,,12 i <br /> N w«ticab6 oral thin I haw selected the rocn<able method of nmmenr,sgrogs,w d'upo I currently s.adable tome which minimizes rM preswl..4 N ,.threat ro human hwlrh <br /> and the smriromosm;OR,if I am a small quantity generator.I haw made a good Faith eibrt to mmrmizs my wrote ganeanon and select the waste management method that is <br /> O <br /> aeaibb6 N me and that I can afford. <br /> > /Typal Name 5lgn9Nre <br /> Z i l l : ; i1'. _ �J 1� - � I t <br /> w F I:. Tram kn in d toI MaMrmk — <br /> w E Primed/i <br /> Sigmmre eh <br /> w P <br /> E 18. Trans nor 2 Ac4now1ad amain of R«ei t of Mare.ials <br /> 1 P,im.d/Typed Name signature Manch Day Veen <br /> w <br /> U 19. Disoepancy Indicanon space <br /> Z F <br /> A <br /> C <br /> 20, Facility nor or Operator CereBcaew of receipt of hazardous manila emend by his monifoss s.ce r as noted In Item 19 <br /> T Printed/Typed Name ."i.SigmNre T� Month Doy Ywr <br /> T <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A p/991 <br /> EPA 8700-22 Yellow. GENERATOR RETAINS <br />