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Form Approved OMB No.2050-0039(Expires 9-30-99) See Instructions on back at page 6. Department of Toxic Substances Control
<br /> Please print or type. Form designed for use on elite(12-pitch)typewriter. Sacramento,California
<br /> UNIFORM HAZARDOUS venerator's US EPA ID No. Manifest Documen 2. Page 1 Information in the shaded areas
<br /> 3
<br /> .-v4WASTE MANIFEST 1 is not required by Federal law.
<br /> CAD 9 8 0 $ 8 4 $ 1 1 6 $ 7 3 5 of
<br /> 3. Generator's Name and Mailing Address A. State Manifest Document Number 25168735 w ^
<br /> a I LGAN CORTAI�R COR-F. 2 .td. S8
<br /> 1$15 NAVY DRIVE
<br /> o STOCKTON, CA 95206 B. State Generator's ID
<br /> to A. Generator's Phone ( 209 ) 466—103 1 MMUSl NCY COITACT, BOX 15I HI Al31 161- 0121 71-21 91 1
<br /> (V 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID[Reserved.]
<br /> op UNIVAR USA INC.
<br /> o CAD 9 $ 1 3 $ 2 $ 4 g D. Transporter's Phone 559-488-4700
<br /> 'ry 7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID(Reserved.]
<br /> CYJ F Transporter's Phone
<br /> V 9.,Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID -
<br /> 00 Q ONYX ENV SVCS LLC AZUSA
<br /> (.0 2 170'.4 WEST FIRST ST
<br /> - AZUSA CA 91702 H Facility's Phone
<br /> rCAD 0 08131012 9 0 3 6�6-334-5111 .
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<br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Containers 13. Total 14. UnitNo. Type Quantity- Wt/Vol L Waste Number
<br /> CELLOSOL'E, N—BUTYL ALCOHOL) ' L Sai4
<br /> G 3, UN1993, PG II, (RQ=100) , (EPA D001) , (ERG 128) D DL/�/Qt}er
<br /> E a o o b G U 1
<br /> b �r t L S e
<br /> c> N0 E METHYL ETHYL KETONE, MINERAL SPIRITS)
<br /> 00 R 3, UN(ERG129) ' PG II, (RQs100) , (EPA F005 D001 D035) , DIM D EIPO/0er
<br /> C14 A
<br /> �p T (DRIED EPDXY COATING) y, , sjoe2.
<br /> 00 O 4.1, UN1325, PG III, (RQ--100) , (EPA D001) , EPA le,
<br /> � R (ERG 133) 01013 DIM S D DOt�
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<br /> d.RQ, t5ULID, Sra e
<br /> Z (OVERSPRAY PAINT WITH METHYL ETHYL KETONE) 3�2
<br /> v 9, NA3077, PG III, (RQ=100) , (EPA F005 D035) , EPAJOther
<br /> w (ERG 171) O DIM
<br /> Q F005
<br /> N J Additional Descriptions For Materials Listed Above K. Handling Codes for.Wastes Listed Above
<br /> O = 11a.' `686369 LIQUID WS'COATIN^v WASTE (WATER) a b.
<br /> llb. DD5466�AZU WATER W'TH ,TP,ACE SOLVENT / OIL
<br /> uj
<br /> 11c. 523372 WATER BASED'EPDXY COATING-DRIED
<br /> 11d..'DDa711—AZ,_ii STRIPE OVERSPRAY d.
<br /> Z 15. Special Handling Instructions and Additional Information WEAR APPROPRIATE PROTECTIVE GEAR WHEN HANDLING.
<br /> EMERGENCY CONTACT; CHEMTRECt 1-800-424-9300. CALLER MUST IDENTIY UNIVAR RS
<br /> Z SHIPPER.
<br /> w PLACARDS PROVIDED B CARRIER/ HIP `J� O DRIVER SIGNATURE FIXI .t.
<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 a4 ]ossified,packed,
<br /> Vmarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government r ' tions.
<br /> IF I am a large quantity generator,I certify that 1 have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be ecarom
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<br /> a practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and,future threat to human health
<br /> to 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 waste management method that is
<br /> W available to me and that I can afford.
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<br /> r Printed/Typed Name Signatures Month Day Year
<br /> 1016101162101
<br /> w T 17. Transporter I Acknowledgement of Receipt of Materials
<br /> w A MTy ed Name C"^ Sig u Month Day Year
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<br /> LU P S -{ a F _. O 6
<br /> w 0 18. Transporter 2 Acknowled ment of Recei t of Materials
<br /> 0 i Printed/Typed Name Signature Month Day Yea[
<br /> Lu E
<br /> N R
<br /> V19. Discrepancy Indication Space
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<br /> — A
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<br /> i f 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
<br /> 4[ T Printed/Typed Name Signature Month Day Year
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<br /> `t DO NOT WRITE BELOW THIS LINE.
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<br /> DTSC 8022A (1/99) Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS.
<br /> EPA 8700-22 To: P.O. Box 400, Sacramento, CA 95812-0400
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