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State of Promotion A,., <br /> Feng APpmwd OMB No.2050-W39(G�tres a3a96) See Instructions on back of page 6. Dapamnem of rmzk sabaarcn cam.ai <br /> Nome prim or type. Farr da —:for vv on aGn f72p(mh1 Hperrilor. <br /> Secroson,California <br /> UNIFORM HAZARDOUS 1. Generm°!s US EPA ID No. hla:ifesf Document No. 2. Page 1 Information in the shaded areas <br /> WASTE MANIFEST k mr?required by Federal law. <br /> �q Q �� 77� 012 0 laf Z <br /> Garro is Na ppe�d Moiling Address 4- Slaft Manifest Doctn. , .qa- <br /> �^ B r� CIO DISC E.R. AND SPECIAL PROJECTS <br /> n .l�f <br /> ^ BRAN /ILLEGAL CLAN LAB P.O. 301 806, SACRANERTO, CA.'-9 06F B.S�Ie rea.afdC>1 <br /> A. Gmmetmw, um B16 ) 323-3600 <br /> 5. rrompenar 1 Company Nome c s bmmT :.717 <br /> 8 b. US EPA ID Number <br /> °0 LAIDLAY ERVIRORNERTAL SERVICESCA Tc. 717i;�.' <br /> ICIAIDA ID 0 0 0181311 I ` imesp `'s <br /> ns6I 8? <br /> Q 7. Traports 2 Company Name S. US EPNumber AZT <br /> >IOa - �... <br /> U <br /> ~Q F'Timspodetrfi.x <br /> imam,tnr.-xve P,.n.S4..�s1 <br /> Z 9. Designated Facility Name and Site Address 10. US EPA ID Number Q+SlptaEiaowy1Dn <br /> 7 z LAIDLAY ENP. SERV. SOOTHY337 , <br /> A O 1340 Y. LIRCOLN STREET _ <br /> t PHOEAI%, AZ 85001 � ' <br /> A Z D 0 4 9 3 1 8 0 01960Sg-6>5_ <br /> Z 17. US DOT Description(ecludmg Proper Shipping Name,Hazard Odes,and ID Number( 72. Contains- 19. Tend 14. Unit y¢ <br /> = I No. T asan+anY Wt Val S <br /> �3 �°' �tJ a ste C�.urfi c /lrsli G.br��l�/ds•(S�iuf•� <br /> o E ltn alta idP lJ) <br /> m N Is. Od <br /> v R I,�o-S I/�T ' Tri e , bre uN7.8.31 <br /> EP*/Ow.Akq <br /> A <br /> � / 0aa12P li ` <br /> T (,tJ Z Co�foSNer� f�jdro Dn`e Sane <br /> R 61 <br /> tk.J �s uA(1 L o ao l 00 d :EPS/a,e <br /> W x bi4s� Xyle .es, 3� gV13071 a <br /> z <br /> �1/ �FI�B ���1 P CEPA/OMr <br /> Olima <br /> �" . I HaodlF g(sd�;f{pwmt,z tuned Aha s <br /> O 75. Special andling Inshddiona and Additional Information <br /> Y3A3 APPROPRI TE PR ECTIV3 GEAR YHILE HANDLING <br /> a Addit' a1 a. bQ SITS: CL36rGLfl96a <br /> Z EP este b, �� �r ttiD R. <br /> r e5'7`� d,Z� y S� cy <br /> Coatact: L-800-535-5053 (5151 <br /> S 3 INFOTRAC Inc. <br /> I& GENERATOR'S CERTIFICATIONt 1 hereby declare than the contents of this consignment are fully and accuratelydescribed abo e <br /> UQ packed,marked,and labeled,and an in all n ro 6y propec national note and arc classified. <br /> recPecm i p pec condition for irmnporf 6y highway acmdk:l to applicable international and national gorommem regulations. <br /> If I am a large quantity generator, I certify,tlrat I hero a program in plain to reduce,the valuse and toddy of wast,generated so rhe degree I have demrmined to be <br /> y xorwmfcofy practicable and That I hero seismed the procskab a"I"d of tradesmen,steraga, or disposal currently a dilable to me whkh minimizes the presam acrd fusre <br /> V) threat to human h.A and the an:siradmer,OR, 4 1 ore o—11 9va,my ganrorator, 1 have mvdo a good faith effort to minimae my wash gm:arandn and sme the best <br /> qk 'easme son method that is Zrul°hM to mad M:ot I can afford. <br /> O P' /Ty me <br /> Mo Day Year <br /> V <br /> WZ t 17. Tram 1 Ackmwled amens of Recei of Manerlah <br /> 0 A Pri Typed /� <br /> W s Q.h Nn rl 1ea1 SON Month Year <br /> Wy '✓L (vW `fll <br /> a 18. Trona '17162 <knowbd of Recei of Mat,rlab <br /> U6 T Primed/Typed Nama <br /> O E S lnaNm Month Day Yea <br /> uWj 19. Discrepancy Indication Space <br /> F <br /> V A <br /> Z C <br /> I <br /> U <br /> I 20. Fodl' Owens or O rabr Cenifieanian of recri t of hazardevs mvhrials covered b MTs manifest exc t as noted <br /> in Item 19. <br /> T Primed/Typed Nome SigmNre <br /> Y Moms Oay Year <br /> DO NOT WRITE BELOW THIS UNE. <br /> DTSC R022A (7/95) White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> EPA VOO-22 To: P.O. Box 3000, Sacramento, CA 95812 <br />