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State of Protection Ayency S�� Instructions on bock of O d O. <br /> Form Ad-.Quad OMB No,2050-0039 IEzp res 9.30.991 11 0appmment of Toel<Substances Conrc <br /> Plaasa print or type' Partin designed for use on alae f t 2-p,whl rypsi-rite, ry Sacramento,CallFarnlo <br /> 1 Generator's US EPA ID No. Manifest Document No. 2 page I Informonon In rhe shaded areas <br /> UNIFORM HAZARDOUS It not required by Federal law. <br /> WASTE MANIFEST G` of <br /> 3. Genomfor't Name Add <br /> a s Y'�b`i "�,/,y• f i(+•.`.,- <br /> �1g� <br /> J .�y�/1 N5 49 D <br /> in d. Cianarorar's Phone{'T� 1 41e <br /> N 5, Transportar 1 Company Name 6. US EPA ID Number <br /> in <br /> a0 r•nsnnu[`r.e.le:n1 t..A..t•s.i.� r. a A An r A A t <br /> , <br /> U 3,0 1 7.43 <br /> °D 7 Tnontpar%p 2 Company Noma B. US EPA 10 Number <br /> A 10 US EPA ID Numhet <br /> S96lSTRIES <br /> 268 PARR BLVD <br /> '�-0 RICHMOND CA 94801 Z <br /> 12. ConralMrt 13 Total 14. Unh <br /> �e+� 1 1 US DoT Deetrlptidn!lneiuding Proper Shipping Noma,Hazard Cams,and ID Number; No. Givantl Wr/Vol <br /> WASTE EMPTY STORAGE C Pis�tf�. <br /> 3 c NON RCRA HAZARDOUS WASTE SOLID p e 4 P <br /> E <br /> S N b i <br /> pyo I E <br /> 41R <br /> A <br /> $ T , <br /> 00 0 <br /> R <br /> d <br /> Z I <br /> U <br /> W <br /> Z <br /> O <br /> V7 <br /> oe <br /> 0 S. Spacial Handling Inettucrione and Additional information <br /> Q Wear proper protective equipment while handling. Weights or volumes are approximate. <br /> Z 24 Hour emergency telephore number: zooLU <br /> 34 dour emer ey contact: tK, DCCT ERG#171 <br /> 16. GENERATOR'S CRRTIPICATIONs I hereby declors that rhe contents of this consignment are fully and arrwan;y described above by proper shipping name and are elawflad,packed, <br /> marked,and labaiad,and are in all respects In prow,oond.t—iar lrari y highway according to applicable international and nationa gavemment mgulationt. <br /> S IF I am a large quanNry generator,I cernfy,that I hove a program in plate to reduce the vaume and tosuci+y of waste generated to rhe degree I haw determined to be sconomlcoilrr <br /> N practicable and that!have-i—fed the ppraetleable method of treatment,oorage,ar disposal currenme which availohle to mwhich minimi:at es <br /> the present and futdre threat to human 1402 <br /> and+a environment;OR,tf i am o mine I quantity generator, haus made a good faith effort a 'nimize my waste generation and salart the bast waste management method that It <br /> ovailoble to ma and char I can afford <br /> 46 Lll <br /> Q Print Typed Name Signature Month Day year <br /> U I <br /> Z <br /> `L' t r T 7, tans ot 1 no sd am r of Real t o azar els <br /> 6W A Prin / i SI never• ,rpt r�^ Month goy Year <br /> :20 <br /> W 0 '8. Tr s rte,2 Aels 1406mmint of Receipt of Motar,ait <br /> Month Des Year <br /> 0 R I Print d/Typed Name Sgnoturs <br /> Vi R <br /> Q A <br /> U I F 19 Discrepancy indication Space <br /> Zj A <br /> C <br /> I <br /> 20 F*c.�iy Owner or Operates-CerttPeatlon of recs,iat aF hazardous materials covered by this manifest except of noted in:Mm 19 <br /> T printed/T ped Name Signalure Monrn Day veer - <br /> �i{ GD D7 Q i f� <br /> DO NOT WRITE BELOW THIS LINE. <br /> DT5C 8022A{'./991 <br /> EPA x700-22 <br /> � � . 1� t'S� ! npy� 6�0�-£b6-60Z Wd£ l�Ol 6661 8l �nd <br />