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to of Colilornia—Environmental Protection Agency <br /> m Approvgd CIMS No_2050-00391Expires 9.30-99i See Instructions on back of p II6. Deportment of Toxic Substances Contra <br /> se punt or type- (Form designed for use an elite f 12-pikh)type 1C�5 Sacramento,California <br /> 1. Generator's US EPA ID No Manifest Document Na- 2. Page 1 Information in the shaded areas <br /> UNIfORM HAZARDOUS is not required by Federal law. <br /> WA57E MANIFEST C AlT O 8101012131318151 8 2 1 0 4 al 1 <br /> 3 Generator's Name and Moiling Address !.� S14t6 fr�andwst F3aturiterst I'f+ratlte► ; � "1 7 ; <br /> PA=C ffi.L i7 coo <br /> 2515 SOUTH ORANGE AVE. <br /> 3r: <br /> A- Generators Phone FFEM CA 93725 <br /> �g pp� 6. US EPR ID Number C $ }eTF{g� <br /> R <br /> LO ON h�, '1' t.�, yr,'• t'�5.,'` %T X` �'; 3. -k,_. <br /> cYJ '1 <br /> NATION, M. ICIAID1016131514t7191916 <br /> 7. Transporter 2 Company Name 8. US EPA ID Number <br /> 9. Designated FacilitX Nome and Site Address 10. US EPA 10 Number <br /> Ryo is &w1ro efrtal Technologies <br /> OC 2081 Hay Road Fault s t + d_r r r if F <br /> r-a <br /> East Pala Alto A CA 94303 C D OI 0 9 4 512161517 i{F.02 <br /> .Pr I'll' .. <br /> 12. Containers 13. Total 14 Unit <br /> 1 1- US DOT Description lincluding Proper Shipping Nome,Hazurd Class,and ID Number) ,1N1/Yol '�'t <br /> No. Type Quantity <br /> Z a s� <br /> _ UM FUMELE LIFIDS, I.OrS.IUSOLM, DIESEL), 3 01993 FGII `V <br /> G RQ (Doll) BIG#{118) D"d T T G , <br /> ER- <br /> # . <br /> o N 6. <br /> ca E <br /> A <br /> o <br /> co Q <br /> R rr c #. <br /> ate, <br /> V <br /> J. A 4"fur 96 Li"fed it s- IC Hpwling. <br /> W <br /> 15, Special Handling Instructions and Additional Information SSSS J A sr 1 y/47 �.. <br /> < KIMMU MFM CALL (800) 917-7701 Fr s rla , OA <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, <br /> Q marked,and labeled,and are in all respects in proper condition For transport by highway according to applicable international and national government regulations. <br /> If 1 am a large quantify generator,4 certify that]have a pro rom in place to reduce the volume and toxicity of waste generated to the degree I have determined to be ecanomicol� <br /> V) practicable and that I hove selected the practicable method of heatment,storage,or disposal currently available to me which minimizes the present and Future threat to human healt <br /> and the environment;OR,if f am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> De available to me and that I can afford. <br /> Printed/Typed Name /�S pH [78EWAt Srg+satur Month Day Year <br /> a� 2Ogr.4i f>e R[7 -7 0 JX- <br /> LLI T 17. Trans oder 1 Acknowled emeni of Receipt of Materials <br /> 1 <br /> ti Printed/Typed Nome Signature Month Day Year <br /> sAn Ic 4 1-y-C W v-Ls � �- L <br /> P <br /> LL- Il 18. Trans orter2ArknowledaemenloFlteceigo1 of Materials <br /> R Printed./Typed Name Signature Month Day Year <br /> T <br /> E <br /> R <br /> 19, Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> ' 1 <br /> l <br /> l 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> T Printed/Typed Signature Month Day Year <br /> DO NOT WRITE BELOW THIS LINE. <br /> ITSC 8022A 11/991 Wkoe: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> PATS8700-22 To P 0- Bax 3000. Sacramento, CA 95812 <br />