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.ate.1 fsHomc--6n«emri+d NorNm+Agency .. _ _ _ ,.c: <br /> :ar•AM. OM"No,2050-0079 r=pir..9-3096) %eeev See Instructions on back of FJ 6 Dean.of T s,.e.a,ee C.-"= <br /> Pkaae'prim w yW. Fenn deignM la use on e6re(12yikh)typewriter. Socron..on,Caiifon" - - <br /> UNIFORM HAZARDOUS Geeeharor s US EPA ID No. Manifest D teem No. 2, Pape T kformorian in the shaded.teakve <br /> p 6 wt required by Federal la . <br /> 7. <br /> WASTE MANIFEST e-Q O 1/ 1/ 4 4 '5I /I of G <br /> 7. GepStatoi a Nwno.d Mailing Addrty I A Sfaa Na.fart Doc�menf Nvnr6nr'�-v �•s+riw�Y`-?-` <br /> o LOJxj_Ix Df A t/Ju.4QuW �� <br /> B. stake G...a,a:.ID <br /> "e' A. Gene ami a Phan. <br /> O 5, Tr eaportw I Company me 6. US EPA ID Nvmoer 1 C Stake Trarvponeh ID — <br /> 7 <br /> D.T,a.pat,rarhone_5"10 235 t83 <br /> B. US EPA ID Nvmder I E. Stake ira,apoEels ID <br /> Q 7. Tronapamer 2 Company Name <br /> JPh - <br /> 1 1 <br /> 71 <br /> F. Transp.sner'a. orn - <br /> 2 9. Daeprated <br /> Favldy Name and Sins Address 10. US EPA ID Number i G. 51vee F <br /> A-Z <br /> 3T say. ` H. F I sPhms , <br /> a _ -.-*1 r__" .Ta.,;:. I _ "I �I �' ,�I =1 -1 '.) - ,,.I —I _I "1 -- 2pa1392 67.2--•-�--- -- <br /> J 12. Comcinen I7. Total 14. Unit <br /> �eee-, 11. US DOT Description Linc ruim Proper Shipping Name,Haeord Class,and ID he.ne eel ' <br /> No. <br /> Tvtx Ovw.tity Wt/Val I Wada Number - <br /> ,' <br /> 3 _ _ _ _ _ !Ul.' I _ — I J 12; ' �I EPA[ <br /> a ' I Sloane, <br /> a <br /> -iI EPA/Otioc <br /> vI R I <br /> I stark <br /> O I EPA/Otho, <br /> z� Rl i I I l l l i <br /> Stake <br /> ► Z d. <br /> W <br /> EPA <br /> `Z 2 Additia�a(Oaac*'Pltau_racMalerwk fated Abve K..NusdWV Gpdt.forwmeccLaad- _ <br /> x <br /> I?=o ' < Tank. nsa Wate 7C - 399 rr �� r <br /> rl I Gasoline-4 m2 DieseI "FuelC. <br /> a r=o€ilz 68956ZRF <br /> ` Z <br /> 'J 15 Special H dhng lron ctiona and Additional Informmion - <br /> Z "s arsencp _.___ ,nse <br /> ` " <br /> 16. GENERATOR'S CERTIFICATION: I hereby deciure than the tonin of this consignment arc fully and a<wrakely described above by proper shipping name and are dosxiiied. <br /> qpacked,marked,and labeled,and are in ail reapecn in proper condition for transport by highway according ro aMik.blo inremarioaal and national govemmem regulanws. <br /> U <br /> -2 If 6. <br /> e I am a large quantity'eneralec"that I I terrify that I have a program in place ro reduce the volume and ai o,y of waste gemnxed to the degree I have determine ro <br /> ecoiwmkdly pracricabk and that I haw ukaed the practicable method of M1 ,manage,or disposal wrrcritly,awilabk In one which minimises the presem and fuNrc <br /> W threat m human haahh and the mwirwmenr;OR,R 1 am a it q..*y r, I have made a good fade effort to mmimice hey wash generation and.1tct the beat <br /> r waste rnanoormere,method that is awilabk ro me ked that I ken afford <br /> e... O Pro (Typed N. MomhYeae— <br /> Ylarc baV Dt- �T <br /> Z 1 17. Thorevahveor 1 Ackeowbd t of Receivt of Materick <br /> P /T Si March Day Tea <br /> ,ee " C 2 oa <br /> W t <br /> W 0 18. T 2 A< wlad eim.o of Recei t of Makeriak <br /> " Primad/Typed Name Siamtvre <br /> o I Momh Day Year <br /> ` <br /> E <br /> t <br /> %ee N 19. Diswpancy Indicadan Span � <br /> V A / <br /> Z c i G/ <br /> — 1 <br /> r k <br /> 1 20. Fedi Owror ar Cer6fk ei t okhasard materia co ani( as noted i 19. Year <br /> T Primed/Typed Name Si 'MO"* Day <br /> Y <br /> DO NOT RI T B LO THIS UNE. <br /> White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> DISC 8022A )1/95) io. P.O. Bos 300, Sacramanro, CA 95812 <br /> EPA 8700-22 , <br />