Laserfiche WebLink
State of CoMomis--Emiremswfd Protection Agency <br /> Fawe Apprmd oAil No.2050-00.99(Epkes 9-70.96) v See Instructions on back o1*ge 6. Depanm r,of Ta.k Substances Camral <br /> Meme print or type. Farm d.;g d for w on eVM(12pildr)ypewmr. Sorom see,California <br /> --[1. Generators US EPA ID No. I Manifest Danresertt No. 2. Page 1 Informalian in the shaded areas <br /> UNIFORM HAZARDOUS b ant required by Federal ksw. <br /> WASTE MANIFEST .A U 0 d 16 ir�tq ,;Z 1& 1/ of <br /> 7. Generators Name and Meffep Address '.,Y a �"a(e C/ A.`Slate Mcr fitl Nssmisir t <br /> o�. . .f.3 _ �.: 955926 <br /> �.s'" . y.�ss3 '1%7.ST.4/ Ge�a�:,, 02746 d , <br /> mt. r��OM — . .L :5.37 - t ." <br /> S. Transporter 1 Company Name 6. US EPA I Number C. Stab T s ll <br /> D. Transporters Phase f.. <br /> 61 <br /> 7. Transporter 2 Cowpony Name 8. US EPA ID Numben E. Stab Trarai les D <br /> Q <br /> n V ` <br /> F. Transporers Phone <br /> V Z 9. xil No and Sire Address 10. US EPA ID Number G.. State Focitily's ID �- <br /> D De °i°c�Cson,4"nc. <br /> V O 255 Parr Blvd, H Fo i1 y',Photo <br /> n Q RidUnond,CA. 94301 (530)235-1393 <br /> 7 V .. 12. Co nine 13. Total IA. Un <br /> n Z 11. US 007 Description�nnckrding Proper Shipping No.,Hazard Class,and ID Number) No. T Wamity Wt/Vol L WOib Number , <br /> 7)� NCtd-PCRA Hazardous Waste IS>lid fzl� I-. <br /> rE Waste E}f47ty Storage Tank. ,.*F ti(;L ri ;�j ? T P P ESptapFe� 1, ` q. <br /> m N Is. <br /> R EPA <br /> cyfi;f�ill <br /> g, <br /> A <br /> T c Slab <br /> 0 ,e <br /> EP6/Oper <br /> w R <br /> Z d, Stab �'o <br /> w <br /> EPA/OIIW >.. <br /> W . 4 1 <br /> N <br /> Z .. "' yb r. f Y K tivdTny Coder fan /pdes listed Above } e <br /> s <br /> 0 <br /> C. <br /> r.' d. <br /> Z <br /> 0 15. Spacial Handling Imtructions and Additional Information <br /> a Me-F, away from sources of ignition. Alp:�ays w-,a- harclhats 4ien harking aru.f v-I <br /> Z TJ.G.S.T. 'a 24 Hr . Canta-:t Nmie._[. _1/yly1 .—_�' Flfrne J <br /> kP <br /> ENERATOR'S CERTIFICATION: I hereby declare that the contents of this conslgnmrst are fully and accurately described above by proper shipping name and are classified, <br /> Qocked,marked,and labeled,and ars in all respecn a proper condition for transport by highway according ro applicable international and national government requlatians. <br /> V <br /> I am a large quantity generator, I certify that I have a program in place to reduce the volume and to.kity of waste generated to the degree I have determined to be <br /> dconomicalfy prmticable and thm I have selected the practicable method of heatmmt,storage,or disposal currently available to me which minimizes Bre present and future <br /> Nhreat b human health and Bre envnonm<nt;OR, if I ons a small quantity generator, I have made o good faith effort to minimae my waste generotian and select the best <br /> LL, aste mono method then a available to me and that I can afford. <br /> Od/Typed Noma Sigmture March Day year <br /> L) 41 <br /> Z 1 Aekrnwkd of Recd of Materials <br /> d/Typed Name Shgralure Momh Day Yearof <br /> W <br /> roof Transporter 2 A< of Recd o1 MMrids <br /> W f Pi /Typed Name Signature Momh Day Yeo <br /> 0 <br /> WN dc19. Discrepancy ksotion Space e <br /> a Is <br /> V A <br /> Z C <br /> I <br /> L <br /> 20. Foci Owner or Oerrzise Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> T I Primed/Typed Name Signature Month Day Y <br /> Y <br /> DO NOT WRITE BELOW THIS UNE. <br /> DTSC s022A (1/95) Yellow. GENERATOR RETAINS <br /> EPA 8700-22 ,. <br />