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Protecliae Agency N%/ See4nstrueNons on back 6,Age 6. Depmenem at Toxic Substances Central <br /> Form Approved OMB b.X150.')079(Expires 9-10'96) _ S«romemo,California <br /> nems prim or typo. Form dasipimd For.se on.lite(llvith)typewriter. <br /> 1. Geroratofs US EPA ID No. Mmifest Document No. 2. Pope 1 Information in the shaded areas <br /> UNIFORM HAZARDOUS - is not <br /> required by federal low. <br /> WASTE MANIFESTiaoi a Y S N °f <br /> / A:stm.Murat oacif(demr FWmber �; <br /> 7. Name and Mail' <br /> Add 5-rA 9 g2 64 <br /> £ �,��ti usA 3��s SRA-> BL �p 95592121 <br /> �stIlBf N x1583 TRa::.>/� cA 9530 B. State GeY H Q 3 6 0 Z 7 g <br /> h <br /> m r crs ID(- <br /> S. TrvaponNr 1 Company Nome 6. US EPA ID Number C. Starts Tamport a � ,y <br /> o v 4 6 3 9 D.Tronsporte/s Ph. <br /> 510 <br /> f 7. Trmaporpr 7 Canyanty Name 8. US EPA ID member E. Stole Tramporte/s ID - <br /> Q <br /> Transporter's Phcsm'C <br /> Q foci and Site Address W. US EPA ID Number GL Sro a f«iTiy/s ID <br /> �;z '' ° is srxiir 'nc. GAov o9 6 G3 2 <br /> 0 25S Parr SliTl. - H. Facility's Ph. <br /> Q R.i• TrrKsr�.CA. 94301 0 0 9 4 6 6 3 9 2 (5101235 1393 <br /> �U 12. Comalners la. Total 16. Unit <br /> n Z 11. US DOT Descriptioe(mcludmg proper Shipping Name,Hazard Class,and ID Number) No. T Quantity Wt/vol I. Waste Number C <br /> 77�_ <br /> s 2 <br /> "U:4-R(MA Hazardous WaSte Solir.7 <br /> 3 G Waste E2rpty Storage Tank. - F;gER-GLq 55 D T <br /> a 4 > <br /> E store. �� -- <br /> 00 y� <br /> < E EPkaK!„' <br /> a R <br /> A <br /> T c' <br /> 0 - EPA/Oddr -r <br /> Al <br /> .State m>. ,I <br /> ' d. <br /> Z v <br /> W <br /> U EPA/ her <br /> w <br /> N K. Handling Codes for Wastes listed Above ” <br /> Z ].'AddeiansvJ --fan Matetlafs Lsped./Ibwc .:• <br /> Qty <br /> N 9 <br /> W I ,. ,—.Tanlc(s),tiave'f3e8(1 •int' :31h �.5 �:: <br /> ]bs.Dsy,'Ice Feac''1000 GalloTl Cavacity ,, d. <br /> 0 15. Special Handling Instructions and Additional Information -- rk a �• t o 1 <br /> .- p'„ 1, y fr-xtl sources Of ignition. AlwavS :+ear harvklar c..tJ-n ;tI <br /> Z it .= j.T. 24 f{r'. !_CXltaCt Naflle.. ��Ll)_ Sx l-'fiCilt'1-Qj00-Z3r_�i123 <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this comignment are fully and«wrarety described above by Proper shipping name and arc classified, <br /> Q packed mad arin <br /> marked,and labeled,and all respects in proper conditionfor transport by highway according to applicable intemafonal and rwlimal 9ovemmmt regulations. <br /> U <br /> If I mea longe quantity generator, I certify that I have a program in place to reduce the volume and tonicity of waste generated to the degree I hove determined to be <br /> deconomically ho.practicable and that I how selected the practicable method of treatment,storage, or disposal currently available to me whcah miizes the present and future <br /> N <br /> threatm hohm <br /> eahh and the onymnem;OR, 'd 1 our a ve small quantity generator, I hamade a good faith effort to minimize m ste generation and ultra the best <br /> waste mamogement method that is available to me and that I can afford. f Month Dary Year <br /> PrkMd/TypSigmlu <br /> ed Name <br /> rK '- GA Fx E i' / <br /> Z 1 n. Transporter 1 A M of R.P1 of Mater s. / month Derr y <br /> A PknT Name <br /> III <br /> W i <br /> W0 18. Tromportter Z A mom of Receipt.ot Alalerw6 yAo,e, pay Year <br /> E Is(typed Name Signature <br /> W T <br /> O f, <br /> W 19. DeserepOrKy krdieation Space <br /> N <br /> Q F <br /> V A <br /> Z C <br /> I <br /> r X). Focil' Owner an razor Certification of receiptof hazardous materials covered this manifest esc m noted in Nem 19. <br /> T Is /Typed Name <br /> Signature Momh Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS UNE. <br /> YellowOENERATOR RETAINS <br /> DTSC SMA (1/95) <br /> EPA 8700—n <br />