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Jun 21 05 01:50p Julie Huber -668-3880 p.2 <br /> Jsa to of Lalilarnla—FnrirOtmsnlal YrOksOrdl Apaney <br /> Form Approved OMB Na.205in-0099 tExpirw 9-70-99) 'So*111iftl' idions an back of page 6. Cfportmem of-oxic Substances Cor. <br /> Phase dint t wpm., Form dssiyrud fanuse on Brite,f p rhi jypewrior. 8acromenw,.^viiia+..o <br /> 1. Genwators WMA ID No. Manil■a,7ocumeni No- 2. Paps I Infornsalion in the shaded anaos <br /> UNIFORM HAZARDOUS It sett tequiredby Fisderel few. <br /> wASTE MANIFEST Z of I <br /> 3. G■seruler's Name and Mailing Address kv 1 N(5 -S A Stwe Manifest Document Nsmbfr 23392183 <br /> ea. -B. Sian G"orororr ID <br /> nA. Generalors Phons L— 1 F.-;q <br /> (V 5. Trantporier 1 Cow—ay Name US EPA ID Nwnbsr C, Wle Transporter's ID R •ved.1 —�•� <br /> h <br /> c° 1t D. Trans ens Phans r' <br /> g rz.Nlr1<:s>,�,f v�i.L.FY wA�iY r>it ! G 4 is 8 7 8 7 1 ,i(Jt?-'�' �its�3 - <br /> m 7. Tramper",2 Company Name Is. u3 EPA.0 Nunsber E. 51ade Tronsporier's ID FRsSlhed.l <br /> Q P. Trenars <br /> porr�r'a Plrae <br /> v P:i4eLl9M1�"�';frf9L1et'l� 1tM�IL'ti 10. USIPA IDNurbr <br /> z 53M OLAU5 ROAD <br /> Fariliy's Phare - <br /> nj 0 I ZI VC143,tiNK- CA 95.367A i Q 0 1 01811 6 <br /> 12. Containers - 17. Total IA. Unit <br /> 11, US D07-Oescriptian{including Propfet Shipping Name,Hazcrc Clots,and ID Nunlbet] No. a Cyontiry WI/Val I.Waste Number <br /> z a. NON-RCRA MAZAI2OOtJS WASTE LIQUID <br /> E "?1 <br /> 3 G f 01 LY 1�11rAiTER 1 [j .I T �. .. �� RPA/Ofh� <br /> 4 <br /> O b Sate <br /> 64 <br /> W E EPA/C11her <br /> A e. Bids <br /> b T <br /> O EPA/Gthar _� <br /> R I <br /> es d Slate <br /> w EPA/ptlwr <br /> LU <br /> V) J. Addlilwol Descriptions for Mawich Gssed Abovv ,ar K. Hoodling Codes for wastes Usted Above <br /> g <br /> OILY WATT R ° 01 b. <br /> w e d. <br /> 4 <br /> 13. Spes;lal handling Inffrocfiaas pad Additional InFormalion <br /> .a �itbtil�gl <br /> z ESI ERGENCY PHONC:BLit#-8E►7-St3'S7 <br /> w <br /> s <br /> 10. GmetATOI'S CERTIFKAMN: I hereby declare*0 theoontants al telt con lon'nenr aro fully and accurately described obove by propersFipping epe.o and are c gasified,pocked. <br /> < marked,and labeled,and ore in all respfelf in M*W candllism far transport by M7g!+ww according so oPp1leable Inwrnatlonol a c nafional yoMrnnsenl regulations. <br /> •Ts <br /> Jf 1 ons a Iw9a quantlyava legenerator,1 certify Thal I how 0 ram 1n place to reds s Ike volume and bxiciry of+ -se gesaratfd to e degrae k tro <br /> Goae pesisave der.rm:ned lo be aconom cclir <br /> s� pracblel l I hkletled IAB practicable prq"c of fredment,stomas,or disposal cur miy available lo,'sre which minimizes the prrgM=nd ILIUM tirear to hwnan keciw <br /> `� enc fk■■nvirOnmeN;QR.iii pen o smell quontify peneraror,I base made good F6W*%tt7o•rnie`m+ze my.v!ste penerotlo-I and wiect The batt waft monogereent method Tho i. <br /> ovailabb to we and Ito+1 eon affard. �. <br /> Plifllyd/TYGd.Name <br /> 1 Signolvn `�"y'-� Month Day Yfcr <br /> t . - - <br /> `s' 17- iro ante.1 Acinonte mens of 6eoe Iol MOM rials <br /> Month Day Year <br /> printd/Typed P1°' ,''f u� C r SignatureA/i— <br /> t f� a <br /> M T>r <br /> P <br /> Q 0lel.Trans anter 2 AcAnorAed ewsel of geeei 1 f Moterialt Manih Day <br /> Yeo+ <br /> ? Printed/Typed r'�� Elpt►ature <br /> w E <br /> U19. Discrepancy b.dicd!on Space <br /> Z F <br /> A <br /> C <br /> 1 <br /> l <br /> l 20. I'Mili Owner of O ro10f Cortiicolion of re of hO 0f materials oaysrsd this Bean" a as nested in have 10. <br /> Y Printsd/Typed None` Signature Month Day, Yeo <br /> V D <br /> ,DO NOT WRITE BELOW THIS LINE. <br /> OTSC 9022A OM Groan TRANSPOiTER R=TAINS <br /> TEPA 5700--22 <br />