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We of California—Environmental Protection Agency <br /> m Approved OMB No.2050-0039(Expires 9-30-991 See Instructions on bock of0.6. <br /> se print or type. Form designed for use on elite 112-pik-hj type r- <br /> ���, 195 Department of Toxic 5ubstrtnces Control <br /> UNI?ORM HAZARDOUS I" �--r s US EPA 1D No. 06 Socromento,California <br /> Manifest Document No. 2. Page I Information in the shaded areas <br /> WASTE MANIFEST C A D 9 8 1 4 0 6 9 0 3 8 2 1 © 1 is not required by federal low. <br /> 3. Generatofs Name and Mailing Address <br /> of <br /> PACMC MJ A- Stupe ManlFest " <br /> 230 CAMINo ate► COEW �'��,j 4P,3E oo a 7 <br /> 4- Generator's Phone PAPA)CA 94558 (9-4.s)X93 = � 'Id b $. srat� eirerafar's ira <br /> & 6- US EPA ID Number <br /> Stale 7roprsrter"s I✓�7 7 <br /> A'�•7l'FA'PT(�� �. <br /> CADaG3s47996 <br /> 7. Transporter 2 Company Name <br /> US EPA <br /> 8. ID Number <br /> _ E:''r�t�trar�sporp&i's�(Res�wtd;) ' <br /> 1'. r�asporr sAhne <br /> 9. Designated Facilitye and Site Address <br /> G. US EPA ID Number <br /> RltaeiC EkAdroiliamtal TtNchmlogies Pacifily s fD <br /> 2081 Bay Road <br /> East Palo Alto, CA 94303 <br /> CAD 0 0 9 4 5 2 6 5 7 _ <br /> I T. US DOT Description lincluding Proper Shipping Name,Hazard Class,and ID Numberl 12. Containers 13. Total 14-i�Unit <br /> No. i Quantity Wt/vol :1. 1y5ts(s f f!iiiber . <br /> a. USTK FLAMMtB LIQBIDS, 11.O.S.(CIIS{1LI116, 019SIL)t 3 6111993 FG11 <br /> G RQ (0011) RK#(121) <br /> i E O 11 T T G . t <br /> E Stare <br /> R <br /> API�tli�r <br /> T ` <br /> O Sldte <br /> R <br /> d. <br /> for O <br /> ' $ ' <br /> awl <br /> F4amflrtr fat a <br /> 0s . <br /> W <br /> a d. <br /> 15. Special Handling Instructions and Additional Information <br /> KIMM I ➢11SPIHISB clu (100) 947-7701 -4- CAry,,�� o�evoq <br /> 16. GENERATOR'5 CERTIHCATFON: I hereby declare Ihaf the contents of this eansig�men{ore fully and accurately described above by Proper shipping name and are classified,packed, <br /> marked,and labeled,and are in all respects in proper condition far Transport by highway accord"eng to applicable international and national{government regulafiohs. <br /> 1f I am a forge quanliy generator,I certify that t have a pr rom in place to reduce the volume and toxicity of waste generated to the degree I have determined to be ecanomicolfy <br /> Practicable and that f have selected the practica6le method of treatment,storage;or disposal currently ovoifa6le to me which minimizes the present and future threat to human "co <br /> and the environment;OR,if I am o small quantity generafar,I hove made o goad faith effort to minimize my waste generation and select the best waste management method that is <br /> available to ro and the!I can afford. <br /> Printed/Typed Name �� d <br /> OF Signator01 Month Day Year <br /> jag L14-0 <br /> i 7. Trans rler I Acknowled ement of Receipt of MaterialsIca <br /> Printed,/Typed Name <br /> Month n Day'l� Year <br /> i' f 8. Trans arter 2 Acknawled emeni of Receipt of Materials 1 4 '•r �' <br /> R Printed/7 d <br /> ype Name _ Signature <br /> Month Day Year <br /> 19. Discrepancy Indication Space <br /> E <br /> A <br /> 120 Facili Owner or Q r Certificolion of recei t of hazardous maleriafs covered b this manifest ex <br /> T Printed/Typed Na <br /> Signature ec t as noted in Item 19. <br /> Year <br /> .c 'Q� -> CS <br /> DO NOT WRITE BELOW THIS LINE. <br /> �8022A (1/94) <br /> 700-22 White- TSD( SENDS THIS COPY TO DISC WIT14IN 30 DAYS. <br /> To P O. Box 3000, Sacramento, CA 95812 <br />