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Stn a ol'Cal'rdln�q�-E�v"Rsne'stol�,matt n agency _ <br /> Farm Approsed OM�FI0.2056'M39(Expires 9-30-94) See Instructions on back o9a 6. <br /> Please Print or type. Form designed far se oat elita(/2p11h) firer. Department of Toxic Substances Carmol <br /> Sacromema,California <br /> 'UNIFORM HAZARDOUS 1. Generator's US EPA ID Na. Manifest Document NO. 2. Page 7- Information in the shaded ren, <br /> WASTE MANIFEST not required by Federal low <br /> 3. Generator's Name and Mailing Address A <br /> o N- h <br /> tCINSON <br /> .. <br /> TOPEKA &SANTA FE RAILWAY a. <br /> IN 740 E. CAANEGIE DR. SITE: DIAMOND & E WORTI — — <br /> N 0. Sra Ge c tats ID <br /> � +: �ra�G �pIN , CA 92406 STOCKTON <br /> m - 4091 ----�---- <br /> 85. Transporter 1 Company Namecis b. US EPA ID Number C. Slane Transporte ID <br /> a <br /> Y(t�`.-/K�L /✓l C. , ! 9 / / D. T p rc Fho e ._- .__-. <br /> J ( i <br /> ��< 7. Transposer 2 Company Name <br /> S. US EPA ID Number <br /> U E Slwe spcnzr z ID <br /> CD 9. Deslgnaed FatalityName and Site Address P Tr sport 'Pis — -- <br /> M� 10. US EPA ID Number G..Sk r fa I ty`x 10 -- -- <br /> CHEMICALWASTE MANAGEMENT INC. <br /> 35251 OLD SKYLINE RD. " F` ly h <br /> M� C AlTj 01 0101 61 41 6j 11 1 / <br /> �Z rb. <br /> Dexdpha (ndvdissg Proper Shipping Name,Hazard Class,and ID Number) 12 Contalne 13 Total x14. U t ------- <br /> _ No. T Ouanti Wt/Vol I. Wast N b" <br /> ETROLEUM HYDROCARBON CONTAMINATED ABSOR®- sr°te <br /> 3 GNT PADS: NON-RCRA HAZARDOUS WASTE SOLID <br /> N E EPA.jana. <br /> a�6 N D M P _ R[LEP <br /> --A T O <br /> R EPa/Ofne--"-- <br /> w <br /> V <br /> W j j j EPA Otte <br /> N I__11 <br /> Z i add ho al Dau pt o,»tar Mutedals lissed Above -- --- <br /> 0 K. Ho d ng Codfrer W.-tel Gsted F ,m <br /> �C— <br /> 0 15. Special Hondlog Instructions and Additio al Information <br /> a 24 HR. EMFRGENCV COPITAC' <br /> Z <br /> _ 24 HR. EMERGENCY PHONE <br /> 6. G1; ORATOR'S CERTIFICATION: I�ereby dechre that the contenh of the consignment arc fully and accurately described above by proper shipping name and are classified, <br /> Q packed,marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable federal,slam and intarnaional I... <br /> V <br /> If 1 am a large quaatity generator, 1 certify that 1 have a program in place to reduce the volume and toxicity of waste generated to the degree I hove-delermned to be <br /> ieconomically practicable and that I have selected the practicable method of treatment,starage,or disposal currently available to me which minimizes the present and future <br /> y1 threat to human health and the environment; OR, R 1 am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the.best <br /> waste marpogenuent method that is available to me and that I con afford. <br /> 0 Prntled/Typed Name Signature Month r Day Year <br /> V <br /> Z • 17. TrornpomeM A,knowlediii2ment of Retcei t of Materials <br /> W R <br /> A Primed Nam , <br /> Vr $igrwls,re;'. Moah D `Year <br /> W <br /> I.W R 18. TmApArler 2 Xcitnowledgervent of Recei t of Mae Is <br /> LL E Prinled/Typed Name Signature Moak Day Year <br /> 0 R <br /> W 19. Discrepancy Indication Space <br /> Q F <br /> U A <br /> Z C <br /> I <br /> L <br /> 1 "r.nled/Typ <br /> r or rator Certification of recei t of hazardous materials covered b this manifest axe t m naafi in Item 19. <br /> rme SignaNm Month Day Year <br /> DO NOT WRITE BELOW THIS UNE. <br /> DISC 8022A (7/92) <br /> EPA 6706-22 Yellow GENERATOCRETARNS'. <br />