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<br />wst of Colifornia—•Environmental Protection Agency
<br />Form A roved OMS No. 2050-0039 (Expires 9-30-99) • ro See Instructions on back Of a 6.
<br />900pnn or type. Form designed for use on *fife (12-pikh) item.,
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<br />Department of Toxic Substances Control
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<br />Sacramento, California
<br />DO .NOT _W ITE BELOW THIS LINE.
<br />DT SC, 8022A (1 /99) Yellow GENERATOR RETAINS
<br />EPA 8700-22
<br />1 , enerafbrs US A ID No. Manifest Document No� 2. Page I Information in the shaded areas
<br />UNIFORM HAZARDOUS
<br />C A L ;t 0> 2 5 1 9 3 1 is not required by federal low.
<br />WASTE MANIFEST f f of
<br />3. Generator's Name and Mailing Addressf` 1 N ] N(L' T4'L State Manifest Document Number
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<br />STOCKTON CA 95206 8, State Generator`3 ID
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<br />4. Generator's PhoneA1,00) !
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<br />5. Transporter 1 Company Name 6. US EPA ID Number
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<br />C. State'reansportePfi ID [Reserved.]
<br />ASHLAND CHEMICAL FHTR IE.?.i1 1, r `" z i
<br />D. Transporter'sPhan *("f17) ii Z`'-4s3f0
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<br />7. Transporter 2 Company Name 8. US EPA ID Number
<br />E. State Transporter's,ID (Reserved.]
<br />F. Transporter's Phone
<br />9. Designated Facility Name and Site Address 10. US EPA ID Number
<br />G. ,State Facility's ID
<br />PCI EA'S'T CHICAGO
<br />H. Facility's Phoni
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<br />c l q ? 197 395 ]
<br />4.341 k.ENNE DY AVE. I i f �t t s.. < :y $
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<br />11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
<br />12. Containers
<br />13. Total
<br />Quantity
<br />14. Unit
<br />Wt/vol
<br />I. Waste Number
<br />No.
<br />Type
<br />a H RZ.cti`0LI.S t45aSte, I IgLa'Id, ,..,?,S,
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<br />1 'Additional Descriptions for Materi�lafustedgbove + # i a
<br />K Handling Codes-for,Wostes
<br />Listed Above
<br />.44 /i4 A44194
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<br />„ 44-43323- A=+433LE3 `d. I
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<br />15. Special Handling Instructions and Additional Information
<br />f_l%EP. ` 4RILL, INCIDENT 1-3F RELEA'C-C If1Vt3I,..`ai%!C- A1; HLANG C<E=i`"•"l�f�L
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<br />16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed,
<br />labeled, in in condition for transport by highway according to applicable international and national regulations.
<br />marked, and and are all respects proper government
<br />If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically
<br />have treatment, disposal to the and future threat to human health
<br />practicable and that I selected the practicable method of storage, or currently available me which minimizes present
<br />and the environment; OR, if I am a small quantity generator, 1 have made a good faith effort to minimize my waste generation and select the best waste management method that is
<br />available to me and that I can afford.
<br />Pr'
<br />Ty Name ,,.
<br />SignaturT---month
<br />Day Yea
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<br />17. Transporter 1 Acknowledgement of Receipt of Materials
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<br />Prinrtgd/Typed Name r
<br />Signaturr;r-,,.e�
<br />Month e<Day Year
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<br />18. Transporter 2 Acknowledgement of Receipt of Materials
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<br />Printed/Typed Nome
<br />Signature
<br />Month Day Year
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<br />19. Discrepancy Indication Space
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<br />20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
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<br />Printed/Typed Name
<br />Signature
<br />Month Day Year
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<br />DO .NOT _W ITE BELOW THIS LINE.
<br />DT SC, 8022A (1 /99) Yellow GENERATOR RETAINS
<br />EPA 8700-22
<br />
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