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tate o ornia—Environmental Protection Agency <br /> arm pproved OMB No.2050-0039(Expires 9.30-99) r• ' See Instructions on back of page 6. Dlpartment of Toxic Substances Control <br />.lease <br /> F•rint or type. Form designed for use on elite(12-pitch)ypev _ Sacramento,California <br /> UNIFORM HAZARDOUS I1. G ors US EPA ID No. .6-1 Manifest Document No. 2. Page 1 I Information in the shaded areas <br /> is not required by Federal law. <br /> WASTE MANIFEST CAL 10 10 10 1040 16 1119 191 17- d j" 6 1 B oil <br /> 3. Generator's Name and Mailing Address A. State Manifest Document Number <br /> RESD—BUILDING & PROPERTY MG-IT. 20087577 <br /> 31 E. CHAIZ,7EL ST. <br /> STQCICTOtI a CA29520 d8-7730 Y B. State Generators ID <br /> A. nerator's 7 <br /> 5. Transporter I Company Name 6. US EPA ID Number C. State Transporters ID Reserved.] <br /> SEOP HAZARDS SOLUTIONS, INC. C A 0 0 0 0 6 4 6 4 9 7 D. Transporter's Phone <br /> 800-746-744 <br /> 7. Tsansporter 2 Company Name 8. US EPA ID Number - - -----_—_ E: Slats-Transporler's{D fReseryed:)— - r_ _ <br /> F. Transporters Phone I <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facilitys ID <br /> AERC r INC <br /> 30677 :3U1dTt70CD AVE. H. Facility&Phone <br /> HAYIARDr CA 94.544 CAD 9 8 2 4 1 1 9 9 3 <br /> nt <br /> 11. US DOT Description(including Proper Shipping Nome,Hazard Class,and ID Number) 12. Coainers 13. Total 14. UnitNo. T e Quantity Wt/Vol I. Waste Number <br /> RQ, NTi <br /> JASTE POLYC:iLORINATED BIPHENYLS, 9, d2315,PG Ste~ 261 <br /> O II 01011 D I M dI& P EPA/Other <br /> E b. State _ <br /> N <br /> E <br /> R EPA/Other <br /> A <br /> T C. State <br /> O <br /> R EPA/Other i <br /> d. State <br /> EPA/Other <br /> J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes listed Above <br /> LIGHT BALLEST CONTAINING PCB"S b. <br /> C. d. <br /> 15. Special Handling Instructions and Additional Information <br /> APPROPRIATE PROTECTIVE CLOTHING <br /> "ELIERGENCY CON'T'ACT: (800) 746-7449" <br /> SEE E.R.G. PAGE 4171 <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 /> marked,and labeled,and are in all respects in proper condition For transport by highway according to applicable international and national government regulations. <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 /> practicable and that IT.selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a small quantity generator,I 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 /> Printed/Typed No Signature Month Day Year <br /> r- CA 10 <br /> T 17. Tronspoiter 1 Acknowled emadof Recei tof Materials / <br /> It <br /> A Printed/Typed Name Signature Month Day Year <br /> N <br /> S STEVE M MEIER C� O <br /> P <br /> 018. Transporter 2 Acknowledgement of Recei tof Materials <br /> R Printed/Typed Name Signature Month pay Year <br /> T <br /> -71 <br /> E <br /> R <br /> F 19. Discrepancy Indication Space <br /> A <br /> C <br /> L <br /> 1 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> T Printed/Typed Name Signature Month Day Year <br /> DO NOT WRITE BELOW THIS LINE. <br /> yellow TSDF SENDS THIS `OPY 'O GENERATOR r11THIN -0 DA"S. <br /> SC 8022A (1/99) (Genercrcrs who :uemir hazcrccos -ante or •rcnsocr• our:rstafe. <br /> A 87022A orccace .erne area -coy :r _coy end _ <br />