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Slate of California—Environmental Protection Agency <br /> Form Approved OMB No.2050-0039(Expires 9.30-491 See Instructions On back O6� Department of Toxic Substances Coma <br /> Please print or type. Form designed for use an elite(12-pikh)ry :itee, ..387612 Sacramento,California <br /> 1,ZAGenerator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br /> UNIFORM HARDOUS <br /> WASTE MANIFEST <br /> `" 0@ 0 2 9 6.2 7 614 0 9 8 of 1 is not required by Federal law. <br /> 3 GanafNpC'cNomemd,[Jtpjligg6dibey„x ' A. Slab Manifest Document Number <br /> 24576478 <br /> 1U555-S saw m7} RR1LlD oAl-Lt3(l[ItO.T C <br /> B. Slab Genaralo/s ID <br /> A. Generator's Phone q"rOCRS(PON CA 95215 (209)463-51311 <br /> h <br /> n <br /> N 5. Transporter 1 Company Name 6. US EPA ID Number C. Stale Transporter'z ID Reserved.] <br /> to <br /> 0 218•t CE2MIRY ENT 3 D. Transporar's Phone (877)748-3040 <br /> 1m7. Transporter 2 Company Nome 8. US EPA ID Number E. Stole Transporter's ID[Reserved.) <br /> J F. Transporbr's Phone <br /> V IIS EPA ID Number G. Stare Facility's ID <br /> IZ2024C 7TM AVFAtF- S4VT(T-1 H. Faciliy's Phone <br /> -O REWF, WA 480.92 9 7 7 1253) 872-80J30 <br /> 0 <br /> )Q 12. Containers 13. Total 14. Unit <br /> U 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No. Type Quantity Wt/Vol I. Waste Number <br /> Z RQ"'BABfE CHRONIC ACID SDblifl% S G41755 @GTI 411002) EQG(154j State 723 <br /> x F G <br /> � EPA/Otho <br /> 3 G 0 c C r ) <br /> E stere 331 <br /> o N 12Q�flH$ii'NFS-',4Dfl115M&I--3- -P�"F--QQ}8NIt1-8QG{1,38-}--.-_ .. �__ - <br /> v R <br /> A XON-i $A NASAQDODS NA54E SULiD stere 181 <br /> ro Q F p EPA/Orbe <br /> R a- <br /> r dIiON-QCKA HAxAQQ+JDc NA3SR LIQUID state !26 <br /> Z F r EFA/Olher <br /> u �; Li <br /> Z yl1 AtLR4ScDl�nsdO�eIsQ-. "bos'4ASQ4-4 (J�) b4�4 ...•w!�@ -- K. Handling Codas far Wastes Listed Above <br /> ZRTn ��C•1 0. b. <br /> d) 115773-12 <br /> W NICKEL SULFAPE IAT18 (2) C. d. <br /> ce <br /> aCut tftfl <br /> Z <br /> 15. 5 a<ial Handlin Inshuctians and Additional Information <br /> Nlug 486PS9 P�OTEC17l"C ^LOTEINfi. ENBRGERC7 H"eSFONSK PHDN3 (8l4J 5hT-7f55. <br /> Z <br /> Z <br /> W_ <br /> H <br /> 16. GENERATOR'S CERTIFICATION: [hereby declare that the contents of Ibis consignmenlarefally and accurately described above by proper shipping name and are classified,pocks , <br /> Q marked,and labeled,and ore in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> U <br /> IF 1 am a large quonliy generator,I certify that I hove o proggram in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economical)y <br /> a, practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and Future threat to human health <br /> and the environment;OR,it I am a small quantity generator,I have made o good faith effort to minimize my waste generation and select the best waste management method that is <br /> a' avoiloble to me and that Icon afford. <br /> Q PriMe d Nome Signa p Mcmtt Do Year <br /> A 106 <br /> WkPrans orbr I Acknowledgement of Receipt of Materials <br /> SignatureMonth Day Year <br /> d/Typed Name aa. o.m.2 Ahnavded a ant of Recei toF Materias Manch Day yea, <br /> Od/Typed NameSignature <br /> Wiscrepancy Indication Space <br /> C <br /> L <br /> I 20. Facilitv Owner or O rater Certification of recei i of hazardous materials covered by this manifest ezce t as noted in Item 19. Monts Day Year <br /> T Printed/Typed Name Signature <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> DTSC 8022A(1/99) To: P.O. Boz 400, Sacramento, CA 95812.0400 <br /> -PA 8700-22 <br />