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Stem ofCafiforn.a�Env.r'same Mel P—t—fie.AQenry <br /> ;, A.,.e A oytg N .0050-0030 K..;_0.3o-001 Sea Instructians an hash o'r je b. Denrimm elTeFit Suhtlontat Cull- <br /> Pfeoso print of typi. Form designed ier use on afila if 2 pitdwrwec Sacramento.California <br /> UNIFORM HAZARDOUS II t 1e^erafor's US EPA 16 No. Manifest Document Na 2. Page I Information in the shaded oras <br /> WASTE MANIFEST I C A C l O r O 1 l 3 3 1 8 a G 4 J 21 ,77) �' C , or 2 's not required by Federal law <br /> 3. Generator's Name and Mailing Address A. State Manifest DocumanrNumber <br /> EVUL'S LIQJOR . . Q. <br /> 0 1405 CALIFORNIA STREET, f SCAURN, CA 95320 8. Stare Generalar':l0 <br /> In 4. Generator's ?hone i 2091 836-7674 <br /> fV S. Transporter 1 Company Nome 6. US EPA ID Number C. $to*TranipwWsin <br /> m <br /> D. Trontporar's Phone f9 371 <br /> o f ::A�X7S Ebil+"IRc'YMF' l'1AL SLUICES C A I� '(i 4 4 C Q 3 1 5 6 1 161 <br /> I 7 Transporter 2 Company Nome 8- US EPA ID Number E.'Stab Transpornr's 0 <br /> J ; <br /> I I 1 F. irrynsporar'a Igrarse <br /> 9. Designated Facility Name ona Site Address 13 US EPA ID Number G. Slate Fad RY's ID <br /> RAYA)S ENVIRONMENTAL SERVICES <br /> 1515 SOU111 RIVER ROAD, WEST SACRAMENTO. CA 95691 li. foarsy's Phone <br /> I <br /> 'C !A fn 4+G r+ 10 10 13 '515 .6 gib 171-5747 <br /> 1 1. U$DOT Description(including Proper Shipping Name,Hazard Class,and tD Number► 12. Conrai ers 1 13. Total 14. Unit _ <br /> No. ype l Quantity wt/vol .I. Waste.Numbee <br /> a. Al Q A,, C Z slogz,z:!� <br /> r <br /> EPArrHft.r <br /> NE b. �,,. <br /> o N <br /> co <br /> R ! I EPA/00w <br /> I <br /> o i C. <br /> I I Stft <br /> co R i r- <br /> { EPA/Other <br /> W I i ad <br /> d. I I stow <br /> ZUj <br /> r <br /> V I ! l EP^70lFrer <br /> W <br /> Lin J. Atfrlt I'D* rot fOrh1 Iii Is Lillad�i6o`e K. Flendling Codes for Was*a L6WAbitive <br /> O _f +�'J <br /> LL' <br /> 0 15. Special Halnd ng 1^struct ons and Additional Information j / sin. L CA 1 ION: <br /> d r1AXDLERS EE 40 HOUR OSRA/SARA TRA}..NEU / // 7� 14L'S CALIFORNIA STREET <br /> w At31'1 LSE ;�IOSii ALP2t}V*'� ?I'E. /�!/ �G>f� ESCALON, CA 95320 <br /> 02RGENCY CMACTt (916) 371-5747 <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare IhoP the contents cf this Con"ignmenr are fully and accurateiy described above by proper shipping name and a-e classified,packed, <br /> morked and labeled,and are in ail respects in proffer condition for transport by highway according to applicable in!ernational and nationol government regulations. <br /> -+ If I am a lane ouantiy generator,i certify that I have a program in p:oce to redace the volume and toxicity of waste generated to the degree I have determined to be economically <br /> o_ practicable a••d that I have selected the practicable method of:ren,rnent,storage,or a`nposal cdrrenlly available to me rhich minimizes the present and future threat to human haoilh <br /> N and the envira:mens OR,if!am a smolt quantity ereroror,'have made a good faith effort to minimize m <br /> q ty g g y waste generation and select the best vasa management method that is <br /> avoilable to re.md that 1 con afford. <br /> O <br /> Pri T ed Name $i nater <br /> >- YP � g � month Day Year <br /> Z _ <br /> 710 cl <br /> 0 T I Transporter t ac Kr."Ied.3ement of Receipt of Mantriais <br /> R <br /> U.4 h Printed/Typed NameL S'nature Month Do Isar <br /> W i ..T w�. la / / Ql yr I <br /> 0 0 18. Transporter 2 Acknowledq•nenr of Receiat of Materials <br /> RPrinted/T ed Name <br /> w E YP Sig a `..•' i Month Day Year <br /> a � <br /> V i9. Discrepancy Indication Spa-e <br /> 91 A <br /> I C <br /> r <br /> L <br /> 20. Focil;ay Owner or Operator Celtificolion of receiot of hazaraous mnrerials covered by this manifest except as noted in Item '9. <br /> T <br /> Y Printed/Typed Name i Signoture <br /> Month Day Year <br /> � I <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A 14/971 <br /> EPA 8700--22 Y'I• OCNERATOR R:TMN$ <br />