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it <br /> •'- Stake AppmAied OMB Nwm 05m-0 Prosection 9.30- <br /> Form Apprord D/6R No.205Q-0039(Epi.93094) See Instructions on back r' age 6. D.panment ofmobs samfmai.came. <br /> %ease prim or type. Form designed for..m etre(12pilo :wnM. __ Sanammto.Caliemla <br /> 1. Generator's US EPA ID No. Manifea Document No. 2. Page 1 Information n the shaded areas <br /> UNIFORM HAZARDOUS <br /> u not required by Federal law. <br /> -WASTE'MANIFEST 111AID1918111415119121of <br /> 3. Generator's Name and Mailing Address <br /> h Santa Fe Railway <br /> 740 E. Carnegie Dr. <br /> N 4 �M�SaR Belrna)rdino, CA 92408 <br /> N <br /> m <br /> d 5. Transporter 1 Company Name 6. US EPA ID Num r <br /> O <br /> n Erickson, Inc. ICiAD0094663 9 2 <br /> J 7. Transporter 2 Company Name 8. US EPA ID Number <br /> V <br /> X) Q 9. Designated Fociltly Name and Site Address 10. US EPA ID Number <br /> Z <br /> Western Drum J <br /> r) 21301 Cloud Way <br /> V u Ha ward CA 94545 ICAD 10 IS 17 2 1 0 13 19 19 <br /> 11. US DOT Desai tan(including Pro SN Name,Hazard[Joss,and ID Number 12. Coma'mers73.Total IA. Unit <br /> Z <br /> P li 9 Per PPi^0 ) No. TType Wan' Wt/Vol <br /> 3 Non RCRA hazardous waste solid <br /> G (Empty 5 gallon pails) <br /> E 10;4 d-64140 <br /> m N b. <br /> V E Won RCRA hazardous waste solid <br /> R <br /> (Empty 55 gallon drums) <br /> m T <. <br /> O <br /> R <br /> w <br /> Z d. <br /> Z <br /> O <br /> 6 <br /> H <br /> W <br /> C <br /> J <br /> Q <br /> Z <br /> Q 15. Special Handling leshuctions and Additional In/ormaniwn <br /> Z Wear gloves, goggles and appropriate personal protective equipment when handling. <br /> W Emergency contact: Erickson, Inc. (510) 235-1393 <br /> x <br /> It -, Stockton L <br /> 16. GENERATOR'S CEItTIHCATION: 1 hereby declare that she consents of the consignment are fully and bccurmely described above by proper shipping name and are cfassified, <br /> Qpacked,marked,and labeled,and arc in all respects;in proper condition for transport by highway according to applicable federal,star*and intematbnal laws. <br /> U <br /> If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of woste generated to the degree I have determined to be <br /> J economically practicable and that I have selected the practicable method of treatment,storage,or disposal cuaemly available to me which minimizes the present and future <br /> threat to human health and the environment;OR,if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best <br /> waste management method than is available to me and that I can afford. <br /> QPrimed/Typed Name Signature Month Day Yea, <br /> Zr 17. Tramiporner 1 Acknowledgement of Receipt of Materials ' <br /> W e <br /> Ur N PH to ped Name G Signature ( U(✓ Mo -Year v <br /> w , % <br /> f o 78. ram omen 2 Ac newled emmt of Receipt of Material <br /> w r Printed/Typed Name Signature ` Month Day Year <br /> LLe _ <br /> Q R <br /> w 19. Discrepancy Indication Space <br /> Q F <br /> U A <br /> Z c <br /> I <br /> L <br /> 1 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 Name Signe; Month Day Year <br /> Y C L <br /> DO NOTTE B O THIS UNE. <br /> J V <br /> DTSC 8022A (7/92) RECEIVED AUG <br /> EPA 8700-22 <br /> Green: HAULER RETAINS <br />