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FEB 27 2002 2;5UPM HP LASERJET 3200 <br />A 6 arm d ' ned for use on elite 12 q <br />1 ID Number- 2. Pape 4 of 3. oy RAapc <br />Aznxaous rr,aatg� �. <br />,MANIFEST ,t �'�..: %.f i' i i , <br />uo?s Name a g Address I 7 <br />#,' �'lI.1 -r Gerlxe a Site Err <br />Farm <br />p.4 <br />ed. OMB %. 20-9&M <br />83 FLE <br />e, Designoad Facility Nama and Sse Address U.S. EPA ID Number <br />RIVEREtAW' ('NL TRAfileIEFi <br />CLAU5ROAD <br />FaJgF,4!4A H1<, CA 95:367 2.Ci3-fttf S• � € B 1 <br />ga• 9b. iJ,S. DOT Description (in dudirg Proper Shipping Name, Flazad Class, ID Number. 10. Coftne(a 11. Total 12. Ung <br />FfM and PwWV. Group (r( arty)( t3, Waste Codes <br />No.. Type � Quantity 4"RNuI. <br />t. <br />MkGRA HAZARncxUSWA," 1.i�JUID AV <br />181ED- (A LY WATErT 0 0"1 T T G <br />z 2. <br />w , <br />V. <br />3 <br />14. <br />15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby,detlars thal the contemn of this ooaslgnmerd are fully and aowmtsF described above by the proper aldpplltg name, and are daesir*d, pacxagad, <br />marked am labaiediplacarded, and are In all respacis in proper ozdition far transport aabrdmg to sp fable lnlemakr al mid national governmental regulations, If export shomem and 12m IN Primary <br />Exporter. I tarlify that the comentsof No oonsgnmanl conform to the lama of the attached EPA A k Aieedgment of Conant <br />I cardly that the waste mlrnmtrallon elatement ldentlAed h d0 CFR 2E2.27(s} 0 lam a terga quantity gareretor'j or (b) (If I am a amaNquantity generator) Is tne. <br />erreral s rn ams NgIN wre Monthay Year <br />w 16, 3ntema Tonal Shomrnts <br />F- ❑ Import to U.S. ❑ EV d from U.S. Port of antryleAt: _ <br />2 Trans s' nature tore% s Date leewrig U.S.' <br />CE17, por'a <br />Transr Adu>o+,Nadgmary of Rmipt of MOoMls I; <br />Trareporter Pn Ahae b ---slgnatwe n year <br />21 Li <br />Trarsporte+ 2 PrintedTTyped Name swasure Month 04 Year <br />18. Dwepanay — <br />ea. Discrepancy Indiption Space ❑ 4uanlity ❑ Type ❑Residue ❑ PaNai Rejection ❑ FW RsieGbn <br />MaArest Reference Numbor <br />1 tib. Abbate Facility (or Genaralor) U.& FPA 40 Number <br />J , <br />� O F1 adoPohe <br />Alternate Fadity (orGwiemtor) Month Day Year <br />y <br />19. H=dws Waste Repot :management Melhod Codes (i.a., codes for hazardous waste treatment disposal, and racyding 3y2tam ) <br />c z. Notice: New federal foam. State of <br />T77 California requires generator to photocopy <br />and mail to DTSC .within 30. days; <br />74. Datignated Facility Owner or Operator: Certification of receipt of hazardous materials oevered by the manifest exoepl ea noted in "o"'20 P.O. Sax 400, $aeramintto,CA 95812-0400 <br />Pars yped Name gnatyro , <br />EFA Form 8700-22 (Rev. 3-05) Previous edbris are obsolete. - GENEitATOR'S INITIAL COPY <br />