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Slams of Pliffirnio—Enviromm nWl Protection Agency <br />Farm Approved OMS No. 2050-0039 (Expires 9-30-99y See Instructions on baf, page 6. <br />Plebes print or type. Form desigrmd for use on elite (12pewriter. <br />Z <br />Z <br />U <br />NMI <br />Deportment of Toxic Substanrkes Contoi <br />Sacramento, California <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (4/97( Blue. GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-22 To: P.O. Box 400, Sacramento, CA 95812-0400 <br />UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br />�/ j� is not required by Federal low. <br />WASTE MANYEST h D 9 2 3 i 7 S 6 a ,) i § ' of <br />3. GegOy(g Q09, p0hV a.Addrev `A::. • r. " sMN6m i <br />RFCD K.V -iGR '.:I <br />3,18o E. cRaPE-.g-rc1e a•kl = <br />I <br />5T0C'K7o14s C A 9SZk S' $lob In sate General.:. <br />4. Ganenror's Phone ( 2,07 ) q69'- 14 1 (p 1 1 I 1 I 1 <br />5. Transporter 1 Company Name 6. US EPA ID Number <br />C. State Tronsp.oer's ID - + <br />I <br />ECOLOGY CONTROL INDUSTRIES 8 2 0 3 01 1713 <br />jgl7anep.rte; s phone _p qps <br />610-235-1393 <br />7. Transporter 2 Company Nome 8. US EPA ID Number <br />- to Transporter's ID -. <br />F. Trnnapar`ar's Phone <br />9. Designated Facility Namand Site Address 10. US EPA ID Number G. State F.ullry's ID <br />ERICKSON INC. <br />255 PARR BLVDH F.mB ie Pane <br />RICHMOND. CA 91801 -,235-1383 <br />11. US DOT Descri tion (including Pro Shipping Name, Hazard Class, and ID Number 12 Coma,ners 13. Total 14. Unit of , <br />P li ^g per ppi g I No. T Quantity Wt/Vol 'I. Wam. Nom6er <br />WASTE EMPTY STORAGE TANK <br />S'°'a 512 <br />c <br />Non-RCRA hazardous waste solid <br />0 <br />o7 O <br />O <br />j� <br />r <br />EPA/Other0QNE <br />E <br />0 <br />Q <br />N <br />b <br />E <br />R <br />A <br />T <br />Stole — <br />O <br />R'vA1 <br />" <br />ad. <br />4 E <br />-: K. Handling Codas for Wastes Listed Above <br />b. <br />15.' Special Handling Instructions and Additional Information <br />Wear appropriate protective clothing when handling. SITE LOCATION: SAME ¢S A QV't <br />24 Hour Emergency Telephone Number. 2o9- N65 -2b1(. <br />24 Hour Emergency Contact 3Et2MoQ�S ERG# 171 <br />16. GENERATOR'S CERTIFICATION: Ihereby declare that the contents of this consignment aro fully and accurablY described above by proper shipping name and are classified, packed, <br />marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and nationaPgovernment regulations. <br />If I am a large quontiy generator, I certify that I have a progrom in place to reduce the volume and toxicity of wash generated ro the degree I have determined to be economicollY <br />practicable and that I have selected the method o treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health <br />Practicable <br />and the environment; OR, if I am a small quantity generator, I have made a good faith effort Is, minimize my waste generation and select the best waste management method that is <br />available to me and that I can afford, <br />jp <br />I�'J <br />• _ <br />e%� Pr <br />Sign ,� ` R�f��,. /) <br />Momh Day ear <br />� <br />p Yr IJJYs�C' <br />e <br />V�(J Y'v F' • .O_A�/2�', <br />� 3 �- 9l <br />S17. <br />Transporter 1 Acknowlodgement of Receipt of Materials VV <br />M <br />Name <br />PAA) /w<,DoNAJ G Lk- <br />S' .bre <br />hbn11� Day �Yeo� <br />S <br />P <br />V7 <br />0 <br />18. Tram rwr 2 Acknowled ement of Receipt of Materials <br />IPrinted/Typed <br />Nome <br />Signature <br />Month Day Year <br />E <br />R <br />19. Discrepancy Indication Span <br />F <br />A <br />C <br />I <br />L <br />1 <br />20. Facili Owner or O eromr Certification of receipt of hazardous materials covered this manifest exca t as noted in Item 19. <br />T <br />Printed/Typed Name Signature <br />Month Day Year <br />Y <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (4/97( Blue. GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-22 To: P.O. Box 400, Sacramento, CA 95812-0400 <br />