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a �' p Capken Afth end 1�'s{to AgerloY r`: TtrxfoSobel• n ••0 .. <br /> AA I t <br /> 1 Sates Control California9 lhroved OM No ?050-0038(EkDlree 9-3091) ♦ Sacramento. elllole <br /> 'f tt <br /> U '}fall dal bI typ (Fomt doe ouod for uSill On aefs h ivX <br /> .e Co 1 <br /> �,tUNIFORM HAZAR OUS 'refor's U9 Menileet information Ht the hawed area <br /> �[""7 -D u of Ia not required by ,ederal law <br /> WASTE MANIFESt - <br /> �. State M a uyyppn1NWb , <br /> f\ E 3.'0enere\or'a Nemo erM M�in9 Addre►e "Y,+� / ✓ � Yy y.l��``"`t-// 1 Q 1 S <br /> ! -0 B. State Generator,a ID <br /> C Generetora Phone C 6irl ) J' ' <br /> 6. Transporter 1 Company Name B. US EPA ID Number C. Stele TreneportefY 1 <br /> S rL&aon9 Inc. rimsponers hone <br /> 7, Transporter 2 Company Name B. US EPA ID Number E. State 17aneportar.9 N <br /> F, ransporter a Phone <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number O. State Feaility's Ib <br /> Inca <br /> Parr Plvd. N. FacIINY'e Phone <br /> t -4clir ,I ca. r�'IE, 1 <br /> ( �- tals�a�s-i3i1� <br /> 12 Containers 13. Tol el nI. <br /> . US DOT Description Secluding Proper Shipping Name,Hazard Class,and ID Number) Qua nilly Unit Waste No. <br /> 11 <br /> ILL No. Type _ WI/Vol <br /> � a <br /> State <br /> 0 Waite duty dt re tn* IMAM EPA/Ortzt-W <br /> N hAa' <br /> as '84)l�fie State <br /> E It, { <br /> R <br /> q EPAl0lhar <br /> T <br /> State <br /> EPA/Other <br /> '. d. State <br /> 1g' EPA/Other <br /> n eeo I data Listed Above <br /> K. Rd "9 Codas for a tittle Uetad Abpve <br /> k; ¢ STI S / III yn/ <br /> I , <br /> « t• 7 ,1 1 , 1 <br /> 15. Special Handling Ineguctlon 4 t <br /> .r p p a and Additional Inlormatlan <br /> 4 >a. F, �t� pYray fcttm s"Yrces of ignitta4 Always wear hardhats wt:FTM� d exi<ir� <br /> arutte U.G.T.ts <br /> i1 V 1S. <br /> '$a GENERATOR'S CERTIFICATION: I hereby declare that the contents of In p open condition <br /> are lusty and t by highway <br /> y described above pl proper terns do name <br /> $ � end ars classified,packed,marked,end labeled,end are In all reaped*In proper condition for transport by highway eccordin0 to applicable International and <br /> national government regulations. <br /> ;. If I em a large quantity generator.I cedily that I have a program In place to reduce the volume and toxicity of waste generated to the degree I have determined <br /> to be economically practicable and that 1 have selected the practicable method of treatment,storage,p,disposal currently available to me which minimizes the <br /> y present and fours threat to human health end the environment;OR,If I em a smell quantity oeneretopg''I have made a 9060 faith effort to minimize my waste <br /> generation and select the beet waste management method that Is available to me nd that I ten e11zTd� j <br /> .i Panted/ yl>y No.. J Sldnatura 1 - Monln DeY Year <br /> !„ II w' t... ice .)tl n <br /> t]. Transporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> 1Z A Prated/Typed Name / _ t, Signature Monts .pey, Year <br /> s �.. L' <br /> P <br /> O 18, Treneporter 2 Acknowledgement of Receipt of Materiels <br /> W <br /> UT Pdnt.571yped Name Signature Month Day Year <br /> E. <br /> 3if <br /> 19. Discrepancy indication Space <br /> r- <br /> A <br /> C <br /> I <br /> L <br /> . 1 20. Facility CTvno a O{IMSIor CeNmcallon of reeNpt of hazardous materials covered by this manifest except an noted in Item 19. <br /> T <br /> y Printatl/Typed Name Signature Month Day Visa, <br /> DHS 00"A(Ifile) Do Not Write Below This Line <br /> EPA 6700-22 <br /> (Rev.9-86)Previous edition*are obsolete. <br /> I YELLOW: GENERATOR RETAINS <br /> z.--rr—.,r�..-.-�.,r-.__�,--,r—.A"-�.!t-w---�---�.'r_;:yr..r..�. ._--.°' -"w.`_ �. ._._ •—. --- --_ _._ _ _ <br />