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ap..ap3V gE.'tE,,,Q„;9 30-991 See Instruct ons an back a e6. .peparhnenr of Toxic Subslanees Corrfrol <br /> cl.signad far use on elite(I 2-p tchJI firer. Socrolowl'a,California <br /> 1, nerator's US EPA ID No. Manifest Docurnenl No. 2. Page I In{ormatien in Ilse shaded areas <br /> C» <br /> U IFORM HAZARDOUS is rlwrequired by Federal torr. <br /> WASTE MANIFEST of - <br /> r l; <br /> 3. Generator's Name and Mailing Address r' s <br /> IdC;MAIi7 I{Aii;X):l C:/0 rtiftIGhT .dAY 111C. ' <br /> LOUI, CA 95240LO <br /> %n 4. Generator's Phone ( 70 9 ) 3 ii J— �y j r <br /> N 5. Transporter I Company Name b. US EPA ID Numberco <br /> I J <br /> h <br /> C A D 2 4 1 7 2 5 5 <br /> fpr; <br /> 7. lronsporter 2 Company Name S. US EPA ID Number la" e 9�' <br /> J .,r '•� I <br /> V 9. Designated Facility Name and Site Address 10. US EPA ID Number 1 �• s )y*_;• <br /> .� 9 {y <br /> �Q BAY5ID";' -DIL It, I:k--. <br /> 210 �1'w� Zi11iL :l ii �j t i4. <br /> O t.u".l "I� r�n ,a 't' = 1, r� li >r r �I C 2 - ~ <br /> Q .l,-, _ 12. ConMiners 13. Total 1 A. Unit <br /> C <br /> 1;. US DOT Deuriplion firsitrrrfing Proper Shipping Name,Hazard Cfess,and Ib Number) <br /> V No. T Quantity Wf/Vol 6 Rr <br /> Z = = <br /> '03 11 i iA.'AKf.ivf1. <br /> o N <br /> co <br /> V A c � ' <br /> o T <br /> co <br /> O <br /> ss.t i <br /> ZJ; Additional Descriptions for Materiels tiled AboveUj <br /> v <br /> O 15. Special Handling Instructions and Additional Information <br /> LU <br /> - <br /> lr <br /> ...!;.G. 171 4-e- v► <br /> Jr 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are Fully nd occuratelyy described above by proper shipping name and are classified,pocked, <br /> Vmarked,and labeled,and are in all respects in Proper condition For transport by highway according to appl"it international and national government regulations. <br /> It I am o large quant;y generator.I certify that I have o Program in place to reduce the vola and toxicity of waste generated to the degree I Gave determined to be econom;coll <br /> Practicable and that F{sowe selected the praclice6le method of treatment,storage or dispesaf rrenlly available to me v hich minimizes the present and Future threat to human heolf(h, <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 /> cc availa6le to me and that I con afford. <br /> O <br /> r Prin d/Typed Name - Signature t Month Day Year <br /> r 1 <br /> j5 17. Transporter I Acknowledgement of Receipt of Materials 1 - <br /> Or A PriNed/Typed N me ` Signature month DayLU <br /> „7 Yso � <br /> to <br /> ts_ p 16. Transporter 2 Acknowledgement of Recei i of Materials <br /> O 1 Printed/Typed Name Signature Month Day Year <br /> u.s F <br /> N R <br /> (1 19. Discrepancy indication Space <br /> Z F <br /> A <br /> C <br /> 1 , <br /> 20. foul; Omer or Operator Certification of rectiet of hazardous materials covered 6 this roan lest except as noted in Item 19. <br /> T Printed/Typed Name - Signature _- J Month Day Year <br /> Y f' 1 ' trif <br /> ,r; i ;'Lf-'L v <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A (4/97) <br /> EPA 8700--22 Greco: TRANSPORTER RETAINS <br />