Laserfiche WebLink
arm npp auto Vmo No.mxrwar Izxpaes r-w-vvl iFee ImFraw.nvua sin wawv. <br /> ^-see pr�nr or ype. Form designed for use on elite(II-pixhJ lypewribr_ W+ fry.a Department of Toxic Substances,Central <br /> Sa<romenb,California <br /> 1. Ga.. 's US EPA ID No. Manifed Document No. 2. Poge 1 Information in dr shaded areas <br /> UNIFORM HAZARDOUS %Wis not required by Fedmol low. <br /> WASTE MANIFEST Arno Q(7 S ' S .6 of <br /> 3. Cmeerolor's Name and Mailing Address A. Side Manifest Documenl PYrin6er O <br /> sac <br /> P.O.BOX 31195;ROOM:kEUDU SAN RAMON !:4'adFM-,A e. Srole Ceierotols ID <br /> A. Genembis Phone I y1. h!!7•7777 <br /> 5. Tmasporter I Company Name 6. US EPA ID Number C. Store Tronspart."ID M.served.) <br /> TI ECobg�GExXSoikY3LSs[i405 1171 <br /> y7 3 D Transpmte'-phon,. 161 oil <br /> 7. Transporter 2 Company Name S. US EPA ID Number E. State Transporter's ID Iw,T,e_ired.) <br /> P TNnsportel>Pbone <br /> 2 9. Designated Facility Name and Site Address 10. US EPA 10 Number !:v Facility,f0 - - <br /> r..w^vI:2C07t+o1 <br /> w <br /> 2087 BAY ROAD ` 's Phone <br /> _I E PALO ALTO CA 94383 - - — - - - - - <br /> r I I US DOT Desai inel din P Shipping Noma,Hazard Class,ood 10 Numbed 12 C b nets 13. Total I A. Unit <br /> Descriptions f a roper 8 No T ouanty Wt/Y.1 L Waste Number <br /> _ Alm Gt`. a-1.. 1',es l.f State <br /> r.-I CRA h3z—dour� h-e--; . /Z53 <br /> :I c (WATER. UCSEL) PROFILE ti 456681 TT B Q Q � EPA Oher <br /> E b __.. <br /> N lade <br /> E <br /> �+ R EPA/Otlscr <br /> A oie <br /> O EPA/Other .. - <br /> iI R <br /> C, <br /> . -Sate - <br /> EPA/Other <br /> liP�({sfstld.(ldTa K. Handling Codes far Wastes Listed Abort - <br /> �'v� <br /> s aF' r d. <br /> HnAing I.,tructions and Additional Information <br /> {lEig3'f rrOewr t\rntcrtliia oust Fszaevtent uvts ilk Fwrl wll:,^.« 1Al�:r+.kstr Or sinl�smnc �r� �TOrn rim�to <br /> is rsOu; esT,eTcy�n�y numc T m X77-7777 a(ti E A,Uu: .1vvV No.1y, PI s�,%rf ka•ee <br /> + ?Q f-IP11 If? --.....-. • +ESRC- TIISPA rrr-'1.� CENT=o ne%T={7t�f1 '1'I a) 544,410,'1 CA <br /> 16, OENERATOR'S CERTIFICATION: I hereby declare tltm tlse conMnh aF tlsi+consig ant an fully atd accuraNy described abma by proper+hi ing name aad are classified,packed, <br /> marked,and labeled,and are in all respecti in proper condition For transport by highway according.applicable international and notional govemmenl regulations. <br /> If I.am a large qw genemror,I certify*11' have 6 Proram in place to reduce the volume and toxicity of waste generated a the degree I have determined ro be ecorwmico <br /> pt�teti<a�lepnd Sle�y e < I¢ys shod of treatment,storage or disposal currently wailabla ro me which minimizes tM present and Future throat to 6vman health <br /> 'vl,dsklyl�df roof �irfs -(gparGW,I have made o good faith effort to minimize my wade gnnerati nand select 0.best..,to managenumt method that is <br /> 1 table tome and that I can afford. <br /> Print yped Noma /Jv� Signature Abnth <br /> 7'� T 17. Traosporkir 1 Acknowledgement of Receipt of Materials <br /> i I R rintad/Typed Name Sig re Montle Day Ywr <br /> t 4c��-- OIt 1"5101t <br /> 1 I8. Tranctene 2 Acknowl emeal of Receipt of Materials <br /> j Pri.W/Typed Name - Signature - Month Day Y. <br /> E <br /> t R <br /> 19. Discrepancy Indication Space <br /> F - <br /> 7 I A <br /> C <br /> I <br /> L <br /> ) 20. 'li net or rotor Cieftific,itior.of receipt of hazardous materials covered bP this yadrift in,cipotof ocAd in.am 19./7 - <br /> TPri kx Na Signabra Mon Y <br /> Y <br /> DO NOT WRITE BELOW THYNIK <br /> RSC 8022A 1/991 White: TSDf $EN I$ COPY TO DISC WITHIN 30 DAYS. <br /> 8700-22 _ - To: P.O. Box 3 Sxromento, CA 95812 <br />