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Stat-of CdifarnlrEnvironmental Protection A en <br /> Farm Apprewad OMB No.2030-0034(Expires 9.3vy 0-99) .SN Instructions on back of page 6. Department of Tonic S brtanps Cann <br /> a lease print or". fano designed for use an allte!)2•pitgh)"writer. Sacramento,Coliforn,p <br /> Al UNIFORM HAZARDOUS 1. Generator',US EPA ID No Manifar Dacument No. 2. Page 1 Infarmoban in the shaded.seat <br /> WASTE MANIFEST , Q z 7 ( /j /� Q a not raqurred by Federal lour. <br /> r ar r <br /> J Ga��ayyeraar's Nomad Ad s � r <br /> y- Al �olzc le �r <br /> A. Generators Phone n T 1 'k��^-"-540 A- <br /> 4A Y �''j+�')• "Y. 6C, <br /> S Transporter 1 Company Name 6. US EPA ID Number <br /> c rail �aSTY �f`9a/st'urllrpk Attu <br /> S A O O IS-1 117 117 <br /> 7. Transporter 2 Company Name A. US EPA ID Number <br /> DeJpnofed Faolhy z nd SI dress 14. US EIA ID Number <br /> 4 ,Q 010 <br /> t2. confamers 13. Total 14. Unit <br /> -tU t t. US Dpi Description!lneiudtng Proper Shlpp7lny,Noma,Hazard Class.and ID Number) No. I Type Ouantl Wt/Vo? <br /> 3 a G M1 <br /> N <br /> 0o E <br /> v R <br /> CNA <br /> S c � <br /> R k <br /> w Id. <br /> Z <br /> w <br /> U <br /> W <br /> N <br /> Z <br /> 2 <br /> W <br /> OC <br /> 4 <br /> Z 1 S. Speuol hbnciling Instrvehons and Additional 186 matlaa <br /> H <br /> W <br /> 16. GENRRATOR'S CIRTIPICATION: 1 hereby declare that the eontenss of Phis eonsignmem are fully and accarorelyy closer,boo above by proper shlpving name and an classified,pocked, <br /> marked,and labeled,ane are.n oil respells�n proper condition for transport W highway occording to applicable IntemoNonal and rwr!onol goMrnmant regulations. <br /> -+J II I oat a large quantity generator,I certify that 1 have o ram.n plea te reduce the volume and toeiciy of waste generated to the dprse I haw determined ro be economically <br /> Nprecnco6le and rhos ave selected the prachcvble methea of rrec i sot,stases,or dlspewl currently erodable to me which minlmisu rhe present and Ivh,ra threot to human haalM <br /> and the environment;OR.If 1 am a small gaantiry generator,I have mode a good fadh effort to minwgis my waste generation and.elect the best waste management method that is <br /> O available to me and!hof I can afford. <br /> Printed/Typed ane Slgnotura Month Day Year <br /> W z� t <br /> Ur T 17 Tran iter 1 mewled mann of Recei t of Mahvials <br /> jPr!n�arTypsd si*Nam. signature i µpDay vpp <br /> �i, 1��ti7" 5Dv wry ��•u,� � �G !! 7 � <br /> O0 18. Transporter 2 AtkAaAsdg4mom of Race, f of mtrwials <br /> R Pr,nted/Typsd Name Signature Month Day Year <br /> W <br /> � R <br /> F 19. Discnpanty Indication Space <br /> l <br /> 20.'Fvjily Owrter or Cogrow hF cat on of riitipi of haaardous ffictigis COMMARV this manifest excelkidk noted[A Item 19 <br /> T I hi /typed Name 9 nat <br /> / h J Manth Ooy seer <br /> �V f DO NOT RIE #E,•LtO—W+ HIS Ni. <br /> D-SC 8022A l4/97j :+,iC ia'% .;Er-!CS .:lr' (i, j C NITHIN 20 <br /> EPA 8700--22 q ' : ?o:: .G':0. ;cC.Omenro -)!Pi <br /> 8 A 6005-8ti6-60Z W V:6 6661 *8l •2nd <br />