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SEP 151199E 11 47AM Q NO 771 P 6 l <br /> of Calrfeml�,--E^•Ironm�Mol Pnal.ctfan 19•n47 S641instructions on back of page 6 Y7� Fb I Oeparims�n�cfnTsrn+o California �I <br /> 4ep,.�d OMB No 2050-=9(EXPlres 434-96) <br /> lomn dnigned for yr oo erde(12VJT V tyPs.^mr 2 Pope 1 Information to fh•shaded areas <br /> pdro or�• Marnfast payment Na lc not required b 1I <br /> 1 Generalars U5 EPA ID No ,c.� eq 7 fedstnl law II <br /> UNIFORM` AS E MANIFEST C 0 q 9� I C� 4 G 1 3 of <br /> 3 Csnerajar'6 Name and illng�Y dress Y St^ <br /> 5 z 3 3a 6¢�d 40� c:� q 56 70 <br /> L [;wsneratrx'a phone ( I 6 US EFA ID Numb- <br /> 5 Transporter 1 Company Name <br /> °P [ ►apy824 � <br /> 3 y a <br /> /?r b r`~e% `JZ.i uC 1.I r•�re S B US EPA I D Number <br /> 7 Trans¢arter 2 Company Name <br /> LJ <br /> 1q US EPA 10 Number <br /> 9 peslgnand Facftiy Nanw and Site Address <br /> LD� I]•1r_�S�r1 ,It1c <br /> ri 255 <br /> r ' <br /> d. C t:1C�lCi1 IZt7,f�* a "'` 12 Containers 13 Taft 1L Unit <br /> 11 U$ 00T 0ucrrppon[incl.dlnq Proper Shipping Nome Hazard Class and IA Number) No T e Quantl WS/vol <br /> Q7 <br /> }y 6 <br /> E <br /> A <br /> T <br /> O <br /> a R <br /> d <br /> W <br /> V7 <br /> 15 Spyaial Handling Inteu0ans and Adefitbnal Infonnofion I t <br /> ~ LCL _ice G ..i fZI <br /> _ <br /> Rohr <br /> IFiGT1ONr i hsrcby daclara that fhe eonrrn y of this ;cnitgnment are f0y and accurately detcrbed obara by proper shipping narro and aro clacsri-c! <br /> 16 GENERATOR'S CERT <br /> 1m Proper condition for trantparf by hiphwoy cccarding tv appticabie lnromcrloncl and nanonal gwornment mgulahani <br /> packed marked and IFICAlabeled and oke rn all respects <br /> mned to Er <br /> Q Tatar I cerTl +at I ho" a program In place To radu<e the eluor anddisp �>�clye"a"a I ae to ,�rated to�h m•ni res !h. pr•zent cmd !yore <br /> a I em a large chcq rK gene y Yraste p&nercnon and select rhe best <br /> eeorsami[alki Pradsagble and that 1 Liars sslocted the practicable method of ertsalTeml hshaveffvo � a goad faith effort ro mrnimlre my <br /> threat 4o human heath and the en.irorimvrdr OR If I am a small quantity 9 mono erner, Yad� <br /> waste n tnotltod that d orgrlable ro mo and TiYat t can vfford Manr`h� Day <br /> ax S,q <br /> tPrlrmrd/Typed Namej <br /> v><P <br /> Z 1 17 Tra r 1 Adk—A—1 ems Qsen of ASaterals Montfi Day Ye <br /> Si no 1 <br /> iei psi d T ams <br /> a � <br /> w s <br /> p 1 Trans ager krdwled anent of Recei 1 Cl Meferlals Mcrhh aay Year <br /> Slgrrature I <br /> � Y Pnr*tedlTyp•d Na <br /> � E _ <br /> e <br /> 19 Discrepancy Indlcarion Space <br /> i,r7 1 <br /> a F <br /> V A <br /> Z C — <br /> 1 <br /> dttfile marl feft sxcno fad rn I •m 19 <br /> I of rc ! DC7 GYear <br /> 120 Poelll Vona <br /> f 57ynarur_; ,f — Q A_ _ O`7 <br /> 7 Fn T yssai N • / ` _ jr�/ rf'' V 1 <br /> DO NOT WRITE BELOW THIS LINE <br /> YNhrte TSDF SENDS THIS COPY 10 DAC 1t I1HIN 30 D.-YS <br /> Ta p O Boz 300() Satramenru CA 95812 <br /> ' <br /> ,TIC 6022-9 (7/951 <br /> EPA BIOD--22 <br />