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STKN .SER .STRT .EQUIP .CO TEL No . Jun 17 ,96 10 :02 No .004 P .02/02 <br /> a III <br /> Form APP oved DMB llh and Wollary <br /> (Expires y9 30.91) —_ <br /> Department of NOallh services <br /> Plena print or type. (iqm designed to,use on e0'Ie(12.pein IYP,vwgm) Toxic Substances Conlrol Division <br /> UNIFORM HAZARDOUS I. Genaralory US EPA No N0. MandaII 2 p _ Sac emsnlo.Cablornl, <br /> ape 1 ImO m <br /> WASTE MANIFEST Doeumenl No. - <br /> ion In IM$netted$cera <br /> G f) Q O ] (] ( ) 01 1 is not requited by Federal ler. <br /> 0. GmpxaloY{Nam.and Manlrp Address A Stals ManitoQt a.7 <br /> Ny)m(9p7r <br /> .. a. Slat.Genaralm'{ID <br /> oo a Oenere,or i Pnone( ) 6 '. r <br /> Ih e. Transports, 1 Company Neole °. US EPA ID Al <br /> w DILLARD TRUCKING - ebb Trans°°rix•{lo rl a <br /> n ClCAlAD 9 8 1 6 91 21 tf I D. Tranapxter'a Phone <br /> T Trani 2 Company Name 9. -US EPA ID NumberTian <br /> 15 G3 - r <br /> E. Blab 71ampMn•ID <br /> F 7r4460Vttxi phone <br /> 9. Designated Fackly Name and Sib Addresst0. US EPA ID Number O. bb Facility,*ID <br /> ., Erickson. Int'. 8 <br /> 255 Parr Blvd. <br /> Rlchroond, Ca. 84801 N F.elmreiu <br /> 7 C A D U O D d G G 1 9 2 r _ <br /> r <br /> ♦�tc <br /> It US DOT 0040/1004 Dncladine Proper Shipping Name.Ilnixd Class,and ID Number) 12. Conrairms 13.TWO Ia. 1 <br /> • OuanUb lY Unit WaaN0. <br /> e <br /> N0. TYP9 wlivol 1 <br /> D . _ <br /> wnyte Empty Storage Tanl(y Slate '512 <br /> E California Regalated Waste Only 0 0 2 T P 1 0 1 0 0 P f <br /> Al r E A/OlNone <br /> Qy E b. I(VV <br /> R <br /> A 81a1e <br /> T L <br /> I+•r O FPA/qMr <br /> g R c. <br /> ® ebw <br /> d. <br /> U <br /> 1p EPAlghw <br /> IA J. Aedi <br /> Empty <br /> DaMPll41 Ix . !. tank, <br /> a k, Hatglinp Cedsa ler Wutea Listed Abore <br /> ��Ylyt��(�(�ant0� ` tank, (12832 Iced w7th�" ,'lbe• ° <br /> a O•y-� lbs. dPtIf 'ke. ;1t.,fnk, 02633 lcet'Wlth <br /> d <br /> rIs. Spacial NanOlinp Inabucnone nett Auto Mlormallon 11 <br /> < I 1 <br /> 2 <br /> I <br /> J <br /> U <br /> to, <br /> J GENERATOR'S CERTIFICATION: I hereby declare that the Col Of In"C"Signmirm are tiny antl accuratsly described above by proper shipping name <br /> a! and at,clea4Xnd,pecked,marked,end labeled.and ars in all ryp0cts In Proper Condition for Irene ort b highway according <br /> to Applicable International and <br /> N national government repletiolts. ° r g v g pp <br /> G N I am a late$quantity penerala,I Cattily the,I have a Program In place 10 reduce the volume and toxicityof wgle generated to the der 1 <br /> 0 to be acon(miCelly practicable and that I have selected the ratlicoble m thod m tris e degree ch m nl i.. in, <br /> present end future IhtNt to human heallh an P e treatment.storage.Or havdise <br /> M 0 Currently loon effort <br /> to me which minl vagi the <br /> p translation and a g d ted s tt O O that is a I(1 am l a smell quantity dthat a an rilb r,I hwa made a good IaXh s/1on to minimize my weir) <br /> 2 select this beat gets mane $moral malnod That is wA1Nwa b ma and foal I un,plford. <br /> Printed am _ <br /> 2 &p at i , Mento Day Vast <br /> c+_..�. 1 <br /> W R ti. Tranepodvr 1 AcknnNedgamam el Recalpt al Melsnals <br /> < N PIMtedl Typed Name <br /> i __T6`-7111-__ <br /> a__;, Month D$Y Yeat <br /> P tw <br /> WO L. Tranaputts,2 Acknewledgamanl o1 promlpl of Materialsr- <br /> < TPnmsdliypea Name +' <br /> ZE Itinerate Month Day Yes, <br /> 19. Dladr9panCY lnOitatbn ypaoe <br /> i <br /> A <br /> C <br /> I <br /> FOOib7 Owner Or Operator Coninl On of'ecalpl el hwardoua materials covered by this manner 9awp1 as timed m Nem 1p. <br /> Y Prinledl Typed Neme <br /> sipn{Iwe Monts pry Yeer <br /> j <br /> DNA eo22 A lee) <br /> TPA er00-22 <br /> Do Not Write Below This line <br /> lay.Fab)Previous at ions ars 06,01919 <br /> YE(IOW: GFNFRATOR RFTAINS <br />