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Form AppTAved OM8 J1o.2050 0039(Expires 30 99J See Instructions on back of pC�96 OA Department of Toxlc Sube!ancee Conrrcl <br /> f lane prim or typo. Form designed lar use on sill@/12-pilchf typewriter. F� Z s Sacramento,Cellfomla <br /> UNIFORM HAZARDOUS I Gonerator's US EPA ID No. Manlfesl Document No. �. Page 1 In(ormallan In Ike shaded areae <br /> it nor requir.d by F¢dmrol law. <br /> WASTE MANIFEST , 8 (� of 1 <br /> 3 Generator's Nome and Molling Addres <br /> Ct cc it <br /> 4. Generoior's Phone (7/i1 1 G 70 j s` 0Z— 1,c1p Ea-- ` <br /> (VS. Trans yl o rNam F/'E(+IV'LY`V Z. 7 <br /> H <br /> 00 <br /> P <br /> WIMP <br /> 7. Transporter 2 Company Nome S. US EPA ID Number <br /> V I c I SII dd a 10. US EPA ID Number <br /> X)d <br /> 2515 PARR IILVD <br /> -Uo RICHMOND, CA 84801 P IAI616131912 <br /> ....I 12. Containers 17. Tolcl 14. Unit <br /> 7 UUU 11 US DOT Description ilncludinp Proper Shipping Nome,Hazard Clots,and ID Number) No. Type Quonlll WI/V.i <br /> 7'Z AGE TANK <br /> 3Ndn-'RCRA hazardous waste solid 0Y 2 P <br /> o N 6. <br /> oma E <br /> e R <br /> v A e <br /> o T <br /> t <br /> Uj <br /> � O <br /> R <br /> d. <br /> w <br /> U <br /> W <br /> H <br /> Z <br /> 0 <br /> Q. <br /> N <br /> LU <br /> Ot: <br /> tl�a�PP�i@V�� f91PP�When handlin . SITE LOCATION: •3"L Z /V <br /> z 24 Hour Etnrergency Telephone Number, �t �®w�S�� - ''h'ce'fwa-1 c'•4 <br /> w 24 Hour Emergency Contact: P� ERGS 171 <br /> f)t 71 <br /> So S <br /> 6 16. GINIRATOR'S CIRTIPICANON: I hereby d.clar4 what the commis of Ihis consignmenl are fully and accurolelyr deacrlbed above by proper shipping name and are dosslhod,pockod, <br /> marked.and labeled,and are In all respeers In proper condition for rronsporl by highway according to applicable intarnol!onol and naflonal government ragular;ons. <br /> 4 If I am a largo qucnfily gamer.tor,I­lily Ikal 1 hove a program in place w.reduce the volume and lonldly of waste generated to the degree I kava dem—Ired to be aconom{cally <br /> N racticable and Thal I have selected the pro oricable <br /> method of treatment,rloroee,or di,pmal currently available to me which minimizes Ihm present and Future threat to human health <br /> and the environment;OR,d I am a small quamlry generator,I have made a good follh efforl to minimize my waste generation and aeloci rhe besi waits managemenr method that Is <br /> te avciloble to me and that I can afford. <br /> 0 <br /> r Prinlad/Typed oma / signator. 7an1l Day Year <br /> .y <br /> W T 17, Trans o ler 1 knawled ¢marl'of fecelpi of Maladala <br /> C� g <br /> 6d A Prinled/Typed Nome Signa0047 r� Month Day Year <br /> � m� Ot�T/ O t ) Q Q <br /> 0 Tp 18. Trans orrer 2 Acknowledge man I of Onceipl of Mato riala <br /> LLJE Printed/Typed Nom. Signatureode Month Day Year <br /> R <br /> U f 19. Dlscreponcyindicodon Space <br /> Z A <br /> _ C <br /> I <br /> L <br /> 1 20. F 111 Owner r O sol rtilicotion of receipt of hazardous materlols covar this mani est exce l vowed In Item 19. <br /> T Prl /Typed Nome <br /> Y Month Day Yeor <br /> DO NOT RIE ELOW HIS <br /> � a <br /> DTSC 8022A(1/99) �`{ `diel-: ISuh SENDS THIS COPY TO I)fSC V•1tiPIIIJ 30 DAYS, <br /> EPA 8700-22 r 7U: Pei). Ila; 3U00, SL Crtt"itStita, Cls 95812 <br />