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Win, Arotechon Agenry'r t <br /> 20, res 9 30 99) I g117 I10iolks Ott <br /> Generators US EPA ID No Manifest Document No.` 2 Page 1 In <br /> UNI'FORAA klA7,,ARDOUSis not <br /> Xr , WASTE MANIFEST t? ;4 { 6 1 7 <br /> a. <br /> � � . <br /> li 3. Generator's Name and Mailing Address <br /> '�`� �AM$ G'"BR M MARTIN <br /> W ' . 315 DWM RCAD BITES TRACY <br /> 10KEe til 95640 <br /> .:..� A.-Generator's Phone( 2u9) ..274-683+4 <br /> S. Transporter 1 Company Name 6. US EPA ID Number <br /> 00 DIWARD U I , INC, C'A Di $ 8 11619121,8 0 9 <br /> X <br /> 7,.Transporter 2 Company Name 8.US EPA ID Number <br /> Wsi noted Facili Nome and Site Address 10. US EPA ID Number <br /> " bE <br /> WUMINOWNe CA 90744 C ]1 D 0 4 4 4 2 a 3 <br /> a 12. Containers . 13: Total I A. Unite <br /> 11,US DOT Description(including Proper Shipping Name,Hazard Class,,and ID Number) <br /> No. T `Quanti tyWt/Vol <br /> � e .a. 0 oi-3 <br /> jolt, �•'�y� Tltt d11 s✓1 Y �11t9 � t <br /> E <br /> ( p <br /> c N b OfM ����"�� 1,•t�r/r t d s , l <br /> a°Do E <br /> v A c. 010h TiA%10101 ISO <br /> T . <br /> 00 o <br /> R <br /> d. <br /> V <br /> Uj X' <br /> h <br /> Z s 1 S. Spacial Handling instructions and Additional Information. <br /> ,{ y � A. <br /> Z aIv 9C phiA ♦ *to <br /> Milt <br /> r r r 9537+8 <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately dribed a <br /> escbare Is proper shipping nand ars <br /> k, marked,and labeled,and are in all respects is proper condition For transport by highway according ta'gppltgoble mtsmatiotta)and notional government ` <br /> -� If I am a large quanh�y generator,I certify that I have a pr ram in'pisco to reduce the volume and toxicity,of wast®generated to the degree i haw deescmsewdt <br /> 4 practicable and that 1 have selected the practicably method of treatment,storage;or disposal currently availabls'to me which mi to the present and fucose: <br /> i and the""ranment•OR,if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and:Elect the best waste <br /> u- available to me and that 1 can afford. t ° <br /> 1, f,.. $ qP.. <br /> a <br /> (?4 Printed/Typed Name Signa a 'n; <br /> w <br /> 17'Transporter 1 Acknowledgement of Receipt of Materials ' <br /> w A Printed/Typed Name <br /> Au A0 <br /> i <br /> LL. <br /> 0 18. Trans r 2 Acknowledgement of Receipt of MaterialsoRa <br /> 1 Printed/Typed Name Signature t k t <br /> Q t �r ° <br /> ' V 19. DiscispancyIndication Space w a r w <br /> Z F � <br /> A <br /> . <br /> Y <br /> kr. tSe - tom r " <br /> ` t 20. Facilityel <br /> Owner or Operator Certification of receipt of hazardous m s covered b'This maniFest ezce}os noted in Item't9 « <br /> ' 1 1; Printed/Typed Name Stgnoture: _'RMe <br /> ,, <br /> ' DO NOT WRITE BELOW THIS 'UNfa �a <br /> w <br /> � �..Y � <br /> •DTSC 8022A(4/97) , <br /> EPA 8700-22 < > Yel6w: GEP[FI{Ai <br /> 4 <br />