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'•2130/2003 14:13 7077471927 UNIVERAL ENVIRONMENA PAGE 03103
<br /> npP'{a.ea6+ne V1o,AVJV-iJUSY iuplres 5.39.943 - ,8B Instructions GFS back Of G E 6. .,-..
<br /> eleasa' rinl or 9 p tea Nilbr P g De partmanl of Toxic Substances t7nl
<br /> . R Ham.•Form Basi ned kr use an elite f 1�• ilehJ $aeramanlo,Colifainto
<br /> UNIFORM HAZARDOUS 1.'Genetatots ts5 FrA1D No 1vlan4e:l bon e,r,t Ho. 2. Pose 1 Informolian in 1hn shaded areas
<br /> "'WASTE MANIFEST
<br /> is not squired rb _ br Federal law.
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<br /> �+ 16. GENERATOR 5 CERTIFICATION: I hereby declare a#rhe[omen oFlhis con=i nment are fully and accurately deicH6914 a6o�a by proper shipping name andare clo i d,pocked,
<br /> tnaAad,and IaboW,and ore In all respects in proper condition m r Frandpovt by highway ocwding to apphcaale inlerncHi al
<br /> and net anal goverrtmant rpgvldRons
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<br /> if I am a large gtranli'I ganereror,1 certify shat I ha.e o proggram in place to rodnce II+<volume aid:vricity of waste gcrerored to rime desrao I hove dererrninad le be etanomi[allyy
<br /> un praetisoble and That 1 116ve ieledad Ilse pracliwbla method of 1realmenl,storage,or disposal currently available ro me w ch nln;m;zes the present and future rhreo#b hamar+haelth
<br /> and Iha onrironrnent,OR,if I om a small quon!ily ganaralar,i hme made a good Ill o foo to minimige my.m a0z genera:ion and select the bosr waste management me3hod Fha!is'
<br /> 6e available so me and Thal I eon offard.
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<br /> 17_Transporter T ckno-jediamiiiiiiiint'aT Receipt OF maleelall
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<br /> owner orQ Operator Certification eF rece;ar of hazardous ma+eri ils cered This man;Fest eroe i as na4d in Ira+19.
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<br /> Atoarh pay Year
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<br /> DO NOT WRITE BELOW THIS LINE.
<br /> W4-Ii=: TSDF 5=NDS HIS COPY TO DTSC WITHIN 20 DAYS_
<br /> DTSC 6022A(1/99) Ta; P,O. pox 3000. 50cromanFa. CA 45212
<br /> EPA$700-22
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