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State of Collornla—Environmental Protection Agency f Form Approved OMB No 2050-00391Expires 9 30 991 See Instructions on back of page G Department of Toxic Substances Control I-Please print or type Form designed for use on elle f 12 pdi typewriter Sacramento California UNIFORM HAZARDOUS is Generator s US EPA ID No Manifest Document No 2 Page 1 Information in the shaded areas is not required by Federal low WASTE MANIFEST V j � T pL of I3 Generator s Nome and Moiling Address A` State Mpnifest Do,aUrrent NumSer� est DSS CONSTRUCTMIN r 6�9 '11,r . `� " }tet. a � [� B^,Stae Gnera tetor s ID a s, ,f� rr ^ r W. CLAY ST., STOC'KTON, CA w ,,, �r �= L04 Generator s Phone I } � w� xa _ _ r N ny 5 Transporter 1 CompaNome 6 US EPA ID Number C25tote Tra isporter's ID[Resin-"edI 'Ar;r- � P � :.x �a�:a -,x4`"'*Jta. TransportersdPhona v'= sr ^w T, D O �, r F ens N3� �k fir_ M ^r°, r*.fi.�s NOR L2 a0 7 Transporter 2 Company Name 8 US EPA ID Numl,er E`tstate Transporters ID[Reserved v q�'S ,*¢� z rib r tsu s -� Fu ns Tiootter's Phone r 3't ,74 Q s _�F . r "� i4. 'F.G +$`s.r.+�rr^r�� V 9 Designated%cili Name and Site Address 10 US EPA ID Number G State Facihty's ID, » v' ;"' - y z 9 tY _ r„t w€ - qs �s r gjysG"r a r„ aim a Q AI~fERICL£�+t3. INC. 1r " t. air tt , " 7 H Fouls s Phone i 25'70 ALMC114D Lift. �/ � UJ w, Y 12 Containers 13 Total ld Unit a ' I I US DOT Description(including+roper Shipping Name Hazard Class and ID Number) No Type Quantity Wt/Vol tf~`,Naste"Ntimber�A `_ Z a .State f" t'A `t 121 14014-RCPA HAZARE)DUS WASTE LIGUID "EPAJOthe , r [UIL.. WA TF-R 3 r � '� f - zu �(VO E b ' stater. opo E PF atr. a n� EPA/Others = Q R < : CN AStateTR EPA/Other 4 �t i � d State U V EA/Other w sn J Additional Descriptions for Materials Lisked Abrove K Handling Codes for Wastes Listed Abovet'` - h Pul rm WATER b "" a y r LU Q Z 15 Special Handling Instructions and Additional Information r r,i;l~`ROPkLATF° PPOI EG"J IVT CL OTUMb a t W "E11ERt3ENFC 1 f,ol1Tr CT c X09) ,41 -r�I45" ' SEE E.F.C•. 171 }b GENERATOR 5 CERTIFICATION I hereby declare that the contents of this consrgnment ore fully and accurately described above by proper shipping name and are closstfied packed Q marked and labeled and ore in all respects in proper condition for transport by highway according to applicoble international and national government regulations V ` 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 hove determined to be economicallyy 0. ILI) practicable and that I have selected the rccticable method of freotmeni storage or disposal currentlyiovailable to me which minimizes the present and future threat to human froolth p and the environment OR if I am a small quantity generator I have made o good forth effort to mmirpae my wpsle generation and select the best waste management method that is Oavadobnd le to me athof I can offord 7/ 7 r Printed/Typed a Signature f 1 MonthDay Year ii -f t } to V L / ZS 17 Trans orier 1 Acknowledgement of Recei t of Moterials r^ LU R W A Printed/Typed NamF -�� Signature r ` c �� ,. Month boy Year ILL- 5 /',j l l rc�: f -r r� 'r-.-. t` ___�,,,.a,¢„_„� ji- r ,d 18 Transporter 2 Acknowled ement of Receipt of Materials r r r t R Printed/T ed Name Sr nature Month Day Year T YP 9 w E R L _ 19 Discrepancy Indication Space F A C ' I 20 Facility Owner or Operator Cernccntion of receipt of hazardous mater, s covered by this monifino except as noted in Item 19 Printed/Typed Norrie Signature Month Day Year r r ' DO NOT WRITE BELOW THIS LINE ' DTSC 8022A 11/99) Yellow GENERATOR RETAINS EPA 8700-22 I