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Farm Approved OMB No.2050-0039(Expires 9.70.991 See Instructions on back at page 6. Department of Toxic Substances Contr <br /> Please print or type, farm designed far use on elite f 12-pikhJ ewHter. Sacramento,California <br /> nerator's US EPA ID No. Manifest Docunea112. Page i Information in the shaded areas <br /> UNIFORM HAZARDOUS is not required by federal law. <br /> WASTE MANIFEST `7 ar <br /> 3. Generator's Noma and Mailing Address C. A. State Manifest Document Num6er 22490637- <br /> � r� <br /> �?so. <br /> So y- s.0,9SAROOM 3C- eea 2 2 4 9 �}U 6t�J <br /> Skit ei RA v4o to n.PI 7 'g 3 r B. State Generator's ID <br /> O r <br /> LO 4. Generator's Phone (9�6 JJ1, `]71- 7?l J 7 <br /> N 5. Transporter 1 Company Name 6. US EPA ID Number Sl�le T r P rPzr s 10[Rr_served = F ` <br /> LO <br /> Y'! U T <br /> A i3 {ar}sporte is�Phnne -- - y f +? <br /> ECOIOGV Control Industries 3 8 2 0 9� 0 1 tT � <br /> m 7. Transporter 2 Company Name 8. US EPA ID Number E ,r. F c pu <br /> Srtf <br /> J <br /> D 9. Designated Facility Name and Site Address 10. US EPA ID Numberiy ,� <br /> Q ECOLOGY CONTROL INDUSTRIES '� '� L� : ,, . �. <br /> Z 255 PAIR BLVD � � RI'�q�n , j,-gps � <br /> lS-. tllJ,ilYrL i�I.S L.aA 91 000101914 6 6 319 L <br /> ' - - 12, Canlainers 13.T Total 14. unit <br /> �V11, US DOT Description(including Proper Shipping Nome,Hazard Class,and 10 Number) No. Type (quantity Wt/vol <br /> = NON RCRA HAZARDOUS WASTE sbLIG <br /> G WASTE" EMPTY STORAGE TANK- 1�r,!"� ,�,'�„� [ �� P �'.. .. �s <br /> dao N 6. -tom 'yam <br /> co E <br /> v RLJ <br /> er¢ <br /> r A <br /> T c. <br /> O <br /> h° <br /> R <br /> ac <br /> UA <br /> AAp a r' <br /> � �� � t', ��i4 g orn�v4atp sa�s=is;�ti�°p !f-•� � �'yp Y �`e �a"�""�'�,'r ,� � � -d '�d F 8 r e � e ..� <br /> r <br /> wi,✓`q yJr;�:„ }- i'�_ # h�'�'�Ssv�',r-'.'` ..Ti �:"si',-"r -_�"i,r” ..+t'�i �'iS o't���4��L"" .e 6r:�r,� `9��`�� �s.+_ 's x�,.,- :a"b��. s,l�.vrsC.' i .a,_. <br /> 1 5, 5 ectal Tiondling In and Additional Am-matan <br /> WEac PROPER PROTECTIVE EQUIPMENT WHILE HANDLING. WEIGHTS OR VOLurvIES ARE APPROXIMATE. <br /> z 24, HOUR EMERGENCY CONTACT: !�V SEC -Le-A <br /> Z5 r4 Lr<r� c. <br /> 24 HOUR EMERGENCY TELEPHONE NUMBER:916 -'?-2-7 -7 777 Eco-'TOB Tc� <br /> 16. GENERATOR'S CERTIFICATION: l hereby declare that the contents of this consignment are fully and accurately described above by proper shipping nom"and ore classified,packed, <br /> Umarked,and labeled,and are in all respects in proper condition For transport by highway according to appilicable,international and national government regulations. <br /> I <br /> If I am a large quantify generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> practicable and that I have selected the practicable method of treatment, 4toroge,or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a small quantity generator,I Rove made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> available to me and that I can afford- <br /> 0 Printed/Typed Name Signature Month Day Year <br /> T 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> a[ A Si v Month Day - Year <br /> LU A Printed/Typed Name nature g <br /> 0 18. Transporter 2 Acknowled ement F R4eipt of Materials <br /> T Pr ed/Typed Name + Signal p Month Day Yet,} <br /> w I,l O 7 1311 10 <br /> 19. repancy Indication Space <br /> F <br /> A <br /> C <br /> L <br /> I 20. Facili Owner or O erator Certification of recei t of hazardous materials covered by this manifest except os noted i tem 19. <br /> T Printed/Typed Name Signature month Day Year <br /> Y eL6 &ZZ13�z�� I <br /> © <br /> DO NO RITE BELOW THIS LINE. <br /> DTSC 8022A (1/99) White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> IA 8700-22 To: P.O. Box 3000, Sacromenla, CA 95812 <br />