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SEP 151199B 11 46AM q 7L.�IO 771 P S i <br /> of Celltomrd-fn�Nn`ru al Ra+aetron agenry See instructions an back of page 6 f D"ITm,nr of To:lc Subviane"Cormal <br /> So-amento eallfornw <br /> Appra+aOMB Wr de Y rf� an e#nr f i2,Rch)hpswrlier <br /> =via pnat or"tyP t C,erreratah US EPA LD Na manfev Occumnrt No 2 Page t Information in the shaded ar%as <br /> Is not retivtrnd by Federal law <br /> UNIFORM HAZARDOUS l a+ <br /> WASTE MANIFEST q! %3or4l 44, 4 4 1 3 <br /> 3 C3ertetatoeos Name ana misng Addlrecc d <br /> Z3 lxr��old Lkec[d0'c�1 w s•I•• � !p l <br /> 6oL4 0 ei— uoo 5v1 <br /> 4 Genaralor%Phone <br /> d US EPw lD Nvmber <br /> S TranspoAer 1 Company Noma <br /> 7 A.. "f/2Qar{ 1 ejJzs c ,o n9 '6 2. B 3 V a <br /> R/D B US EPA ID Number <br /> 7 TTenrporler 2 CcmpanT game <br /> 4 peelgnaMd f'adlrtY Nano and Sire Address <br /> 10 US EPA ID Number <br /> LO� A1C}:SDCl YriC <br /> F1j 1] 1 { <br /> 12 Comaman 19 Tolal 11W/Vol <br /> C01 11 US DOT Proper Shipping Name Howard Class and IO Numbof) No T Quanwy <br /> LI' <br /> D - I✓r� ttr �u7r game, 4 O T i' d o 0 <br /> E ` <br /> N la- <br /> v E <br /> n R <br /> T <br /> T <br /> � R _ <br /> d <br /> r <br /> U3 <br /> in <br /> Cr <br /> 15 Special Handling Inttruchons and Addhlonol Information v r7 <br /> l r_ cm r ' 1�1�1 1 <br /> Z i I3.i <br /> decla a than the content,of thlc coq gnment are fully and accurately described oba.e by prapor shipping mama and an ciasslfled <br /> 16 GlNERATOR S CERTIFICATION I hereby <br /> lcabl•mforngnonal and nataar+al Qaverrlmenl regulations <br /> Q packed marked and labeled and are in all tesp cm in proper candrrton for transpart by high"acmrd+rp to app r <br /> If I am o large quarnityr generator I comfy that I kci e a program in plate to reds a she r 1evs and tovIcIty of wos" gaaarct%d to the degree I have denrmand future <br /> msed to be <br /> ecor.omkalty provIcobta and that I haw selected the praeiea4le methal of titraratmr�I ha a ntade arage or lto d{aril, eepowl lifrid to minlmlie my y available lo me hwste 16 rgenororon anrhimIza%*0 d ielea the best <br /> N thrwat ro human health and the environment+ OR rf I am t small quarrMy q <br /> waste mane merit method iter Is avotlobts to me and that 1 can afford mo nye pay Year <br /> Pnnt%d/Typed Mama S`gm 7 <br /> T t7 Trans erfer 1 Acknowled %creat 0MI o1 AAC"nals frtiostlk paY}y QYear <br /> Pnr aped Name <br /> Sig r <br /> s <br /> p19 Trvnt r 2 Acknewled em%nr of fiec%l I of Marerlals Slgrrertrn Mormh pcy Ycar <br /> E pnrand/Typad Name <br /> O L <br /> 19 Discrepancy Indlcmtton Space <br /> A <br /> Z C <br /> I <br /> 20 Facrl Owner or O r Csrtlflcahan of neer of hawrdous materials vend b ihu ma��nlfact eKcfe)r as noHd In Item 19 <br /> 1 51gn� v '! rteEr pay Year <br /> T Prinhsd/Typed Name O -7 <br /> Y �/tO _ / ! f <br /> DO NOT WRITE BELOW THIS LINE <br /> Whirei TSDF SENVS THIS COPY TO OTSC WITHIN 3t, DAIS <br /> To, PO Box 3000 Sacramento CA 958~7 <br /> 9T1C 8022,* (1195} <br /> ' EPA 9706-22 <br />