Laserfiche WebLink
State of Cplifornio—Environmentol Protection Agency <br />Form Approved OMB No. 2050-0039 (Expires 9-30-96) See Instructions on ba, <br />Please ftiint or type. Form designed for use on elite (12 pewrifer. <br />UNIFORM HAZARDOUS IT. Generator's US EPA ID No. Manifest Doo <br />WASTE MANIFEST CAD 19111111,1 81 13 1414 <br />3. Generator's Nome and Moiling Address 104 <br />PACIFIC GAS & ELECTRIC CO_ MCDONALD ISLAND COMP - <br />to <br />P_0. BOX 106 STAT - <br />C4 HOLT, CA 95234 <br />V) 4. Generator's Phone (209)944-1400 <br />tb <br />00 5. Transporter 1 Company Name 6. US EPA ID Number <br />a' ALLWASTB TRANSPORTATION & <br />REMEDIATION INC_ 01 q 151419 <br />J 7. Transporter 2 Company Nome <br />8. US EPA ID Number • <br />V <br />NQ <br />® Z <br />M 0 <br />CJ <br />L0 u <br />clo <br />LO <br />j 3 G <br />c' E <br />0 N <br />4 E <br />c'R <br />V A <br />d <br />o T <br />00O <br />R <br />w <br />t— <br />Z <br />V <br />W <br />rn <br />Z <br />0 <br />a <br />w <br />J <br />Q <br />Z <br />0 <br />H <br />Q <br />W <br />J <br />Q <br />V <br />a <br />N <br />a <br />O <br />V <br />Z T <br />W A <br />O A <br />pC 0 <br />LU 3 <br />P <br />W U <br />9. Designated Facility Name and Site Address 10. US EPA ID Number <br />C[M ICAL WASTE MANAGRffM, INC_ <br />35251 OLD SKYLINE ROAD <br />KHTTLEMAN CITY, CALIF- 93239 I q AI 01 01 q <br />11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) <br />7 <br />"-RMA HAZARDOUS WASTE SOLID <br />(SOIL & DEBRIS CONT/W OIC.) <br />C. <br />d. <br />page 6. Department of Toxic Substances Controi <br />Sacramento, California <br />lo. 2. Page 1 Information in the shaded areas <br />is not required by Federal law. <br />I of 1 <br />12. Containers <br />No. I TvDe <br />,11X Di MA <br />13. Total 1 14. Unit <br />P <br />15. Special Handling strjQT1jVE <br />dditional J�'��TION CERTIFICATION CNBC® 8_R� G_..# <br />i�s7 Is <br />lla_ SAP ORDER #: <br />24 HOUR OONTAMATZMASTB INC_/LRE SOARES 11b_ 171 2009146 <br />800/321-1030 11C_ S_V_M_R_ <br />WEAR CLOTHING & FYRWBAR SITE ID:20-T lld_ #11 <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, <br />packed, 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 quantify generator, 1 certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree 1 have determined to be <br />economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future <br />threat to human health 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 <br />waste management method that is available to me and that I can afford. <br />Printed/Typed Name_n Sign r - -- — . <br />0 <br />tE�6 ILI <br />of Receiot of Mater <br />18. Trans orter 2 Acknowled ement of Receipt of Materials <br />Premed/Typed NameSignature Month Day Year <br />N 19. Discrepancy Indication Space <br />Q F <br />U A <br />Z C <br />I <br />L <br />1 20. Facility Owner or Operator C <br />T - Printed/Typed Nome <br />Y <br />as <br />Signature <br />DO NOT WRITE BELOW THIS LINE. <br />Month Day Year <br />DTSC 8022A (1/95) Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-22 To: P.O. Box 400, Sacramento, CA 95812.0400 <br />