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alara or Uruiorn, --ri641 vrp --r. I . <br /> St38 Inst[ oft age ti Qpa�rRent„ <br /> F Agpov' -§•say roxioc5uti"t w i� # <br /> b . 171 <br /> Pae qR: is <br /> • a a 2: Pays ) Intogn4 iort in the a [ <br /> oT ` Is <br /> � 4." eeratdr'a Phone <br /> 6., $ybrnr 1 amppny Nlam]sa 6. US EPA IDN er a[ ffa <br /> LO n <br /> CP <br /> 7. Transporter 2 Company Name 8, US EPA iD Number tx oifor'sco <br /> '. <br /> Y <br /> 9. Designated Facility Name and Site Address 10.- US EPA ID Number "E <br /> Erickson, Inc; <br /> y 255 Parr Blvd <br /> a Richmond, Ca. 94807 CAD 0 0 191.41616131912 <br /> Q 12. Containers 13.Total 14. a% <br /> e 11. US DOT Description(including Proper Shipping Name.Hazard Class,and ID Number) Quantity Unit p,. .. <br /> No. Type Wt1Vol <br /> a a•Waste Empty Storage Tank <br /> N <br /> BOH-RCRA Hazardous Waste Solid. Q P 0 <br /> E b. <br /> Slat 'a•' <br /> a R <br /> A <br /> T Av <br /> 'N O <br /> R c• "s <br /> Wd. State <br /> Z <br /> Us r <br /> W <br /> W J Additional;l3aaulptbnafow Materiah ListedFla�ndlIn codes for Wiate t1 ts,"Altdve' <br /> �' Q> a to t Stora a Ta• �" <br /> � _. <br /> e `Q'000 C41.x <br /> fes, 15. Special Handling Instructions and Additional Information <br /> Keep away from sources of igni 1.an:. Alwa s wear hardhats when working around <br /> { U.S.T: rs 24 Hr� Contact Name & PhoneWto .� <br /> �a <br /> J GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name <br /> and are classified,packed,marked,and tabeied,and are In all respects in proper condition for transport by highway according to applicable International and <br /> CL N national govemment regulations. <br /> Q If 1 am■large quantity,generator,I certify that 1 have a program In place to reduce the volume and toxicity of waste generated to the degree I have determined <br /> O to be economically practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the <br /> >6 generation <br /> and future threat to human health and the environment;Oft.if I am a small quantity generator.I have made a good faith effort 10 minimize my waste <br /> V generation and select the best waste management method that is available to me and at I can afford. <br /> Printe /Typed Name Month pay Year <br /> W Y q4 <br /> W <br /> ws T 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> u_ A Prints ". , ed ams Sion Month Day Year <br /> Nyll-� 3 <br /> O Pi <br /> W O 18. ransporter 2 Acknowledgement of Receipt of Materi <br /> a T Printed/Typed Name Signature Month Day Year <br /> U E <br /> Z <br /> 19. Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> 2o• Facility owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Sem 19. <br /> Printed/Typed Name Signature Month Day :Year <br />'D'S 8022 A Do Not Write Below This Line <br /> 8706•-22 <br /> ey;84i9)Previous adiflons are obsolete. <br /> White; TSDF SENDS THIS COPY TO DOHS& I 34AYS <br /> To: P.O. Box 3000 Sacramento C� 5812 <br />