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State of CoGfomlo—Enwenmemol Protection Agenry — <br /> .'.Fo,m Approved OMB No.2050-W39(Expires 93696) , See Instructions on back of '109e 6. Department of Tori Svbuaae.Conus' <br /> Please prim or type. Form designed for wa on lite(12pie ewriten Sacramento,California <br /> UNIFORM HAZARDOUS Generat°ry,US.EPA.ID No. Manifest Doei,incol o. 2. Pape 1 Information in the+hoded areas <br /> WASTE MANIFEST is no required by Federal law. <br /> ^ 01 <br /> 3.'Generator's Noma and Mailing Address Ars5lah ni(etCDo miA'Nombe <br /> sn AMEP.00 REAL ESTATE/U-HAUL IS7MATIONAL C <br /> - 2721 N. CENTRAL AVE. , 6700, PEORNIT AZ 85004 sae*ce rl� a Yr JI <br /> m 4. Generator's Phone (fj{�'JI 263-56/i i s .TtC `v .ay:.,. ! ,c• :`� ..1 _.. N �. }t" -:> u. Ti <br /> 0 5. Transporter 1 Company Name 6. US EPA ID Number '-C?St.IeTra'tiipeMers ID�.'aF"Fj. .` " <br /> W /- AR <br /> J <br /> T) 1 SERZy rIA11,19121711 171 <br /> •D:'TiSilfpo'r}ers7hbri'e." t+Friag'r .�:.<.:�t,$"::�t .• ; <br /> Q 7. Transporter 2 Company Name S. US EPA ID Number els IantrSfiiteGD <br /> �: pl <br /> o U L <br /> Z9. Designated Facility Name and Site Address 10. US EPA ID NumberG! D <br /> 0 DeMENNO/KERDOON <br /> 2000 N. ALAMEDA ST. Ff faa v ' a i-� <br /> m ,r T'h' Pjidi7p ,. <br /> �� CO3k PTON, CA 90222 I C A T 0 8 0 01113131512 ..,' . _ >.=$I <br /> 11. US DOT Description mcbdin Pro er Shipping Name,Hazard Class,and ID Number 12. Contoinen 13. Total 14. Unit V' f <br /> OZ9 P ppi9 ) M / _ <br /> Na. T Want' Wt/Vol <br /> Vol ase m e1 <br /> 3 a'(OIL & WATER) NRON—R.C.R.A. may. <br /> G FAZARDOUS WASTE LIQUID 0 0 1 T G iEPA7 <br /> 0 E �jyj <br /> � <br /> N b. <br /> E <br /> R EPAr r <br /> d A <br /> O T c. <br /> N O <br /> oc R AryOfw <br /> W <br /> Z d. <br /> W <br /> U ' <br /> y <br /> 0 1 Additional Dwripfbrirf61,Mafenals Lfrted Abovf} c'Lis s a s' _"+x - IC.-F1andlinq Codei`fer;Wastes.,Lite3s <br /> 4if.Fv�iiy .4., ay0! ;kyl ' "mss ` zY Nex r d <br /> Zwe„ T +z?'. s«.L. d FiD"' `t..�rA" � '•5�" 5 _1F2r ll•+:.} <br /> O 15. Special Handling Instructions and Additional Information <br /> Z DON PROPER PROTECTIVE GEAR U—Haul 709-83 <br /> NO SMOKING; E.R.G. R27 450 Ne Cherokee <br /> E'MRGEKY 6: Lodi, CA <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately detcribad above by praper shipping name and are classified, <br /> U packed,marked,and labeled,and are in all respects in proper condition for transport by highway according a applicable intem stional and nationammen <br /> l govel roguletiorm. <br /> If I am a large quantity generator, I certify that I have q progrom'in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br /> yeconomically practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future <br /> N threat to human heads, and the environment;OR,if 1 am o small quantity generator, I have mode a good faith effort to minimize my waste generation and select the best <br /> K 1 wash management method that is available to me and that I can off rd. <br /> O yLnoted/Typed Not / / 0nature / rI Month Day;' Year <br /> > 1, r /' <br /> Z17. Transporter 1 AcIes wled ement of Receipt of Materials <br /> W It <br /> 0 „ Printed/Typed Nome sign ;9 t / Month Day Year <br /> ,y 0 18.'Trons oder 2 Acknowled ement of Receipt of Materials <br /> Ninted/Typed Name Signature Momh Day Year <br /> O F <br /> A <br /> 0 19. Discrepancy Indication Space <br /> U F <br /> U A <br /> Z C <br /> I <br /> E <br /> I 20. FacilityOwner m Operator Certification of rscelor of hazardous materials covered b this manifest except as noted in Item 19. <br /> T Printed/Typed Name Signature Momh Day Year <br /> Y '' <br /> / / % <br /> ,: ; _ , : T L:1 2. 7 <br /> DO NOT WRITE BELOW TH15 LINE. <br /> DTSC 8022A (1/93) Green: TRANSPORTER RETAINS <br /> EPA 8700-22 <br />