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JUN-07-99 09 :34 AM JOHNS EXCAVATING 707 571 8759 P• 07 <br /> 51aq of Cclifotnia—EA•frontnental Prolecfion Aaancy 4" .'j.5 1)W <br /> Form App+oved 0I41 War 1030- 391E:pirol 9•]0.991 SOC Instructions on back of paa 6. 0aaa4mam of Tome Svbsroncer Ca+lrol <br /> 1. I'leau print w". form dyuQned for use On ally(1 j•prhlrf rypr.erirsr, -1$=/ Sacromenlo.California <br /> UNIFORM HAZARDOUS 1. Generolor's US EPA 10 No. lwanilesr Document No. 2. pogo I lnformarlon is+he thaded Gnat <br /> is not required br Federal le.. <br /> WASTE MANIFEST Q 0 1 :� 4 '� 3 1 <br /> 3. Oenerolor's Memo and Matting Addreta <br /> sr1 I. Caneraor's tlhone 190 +;.� '• 'i' �: <br /> H3. Transporter I Company Name 6. US EPA iD Number . <br /> g FULLER EXCAVATING AND DEMO 10 a ' ,��, 9 ,"1 Is <br /> DO 7. Tronsfswer 2 Company Neree 8. US EPA M Number r. +�'�" e, �r n'•i�fry;!- :irS '`ii.l. �� I <br /> Sr, On+gnatsd Poallly►+lame and Site Addrau 10. US EFA Ip Number Sl!�cf }.I R;'��'S•,1'} '�. '` s <br /> A ERICKSON INC. D A g q <br /> Az J. <br /> 2�3 PARR BLVD <br /> f: .�� •`' .9 <br /> oRICHMOND, CA 94801 <br /> w R ' <br /> 17, Conlainsrt 13 Total IA. Und ;. i, r <br /> 11, US DOT Dascriprien ligcluding proper Shipping Name,Hazard Class.and ID Numbed ftp Type CuanYh wl/Val f; 1 <br /> r WASTE EMPTY STORAGE TANK r s ` <br /> �3 c Non-RCRA hazardous waste solid TP !, 1010. <br /> m E � <br /> v � <br /> A d <br /> T <br /> m O <br /> p <br /> s.2� t <br /> p <br /> ti ;.� - x:: t iC•'' i Codes r,Vllalu�ls A6q' , i}r <br /> N ., ,{Fl + a� �e�;ti' -�+. .z •d' � � i <br /> � "� - ::�.���-gfi'.�iY..,� .s:;.i�•r��!� I� =� <br /> at riY r7`e `-I Y is1 T �r r�UjE 'e'•}`.IL., '. i�r' <br /> / T •F�'''r• l...if <br /> 1 S. spac;ol Handling Instructions and AddAienal rnformariott <br /> Wear appropriate protective clothing when handling. SITE LOCATION: 15-�eL <br /> 4wa��. <br /> 24 Hour Emergency Telephone Number: 51b- �-Zqf I-ggdl ERG 17 <br /> � 24 Hour Emergency Contact: 00 9A L 5-rpu <br /> 16. GENERATOR'S CEF:T119CATfGNI I hereby declare that the coMenti of thte coesigntnset are rally and accurately dewlbed also••by I leper shipping name and are clateifled,pae�ttd. <br /> ma+►ed,and labeled,and ore In all retpech in Proper cond}Ilon lot transport by hiyhray Pccording to applicable ImermaNapal and national ge•ernmers+regufatlons, <br /> V <br /> II I am a large uuanri generator.I certify that I hove a progrom in place ro reducg the+Visine and toxicity of waste ger•erafed to the degree I hG-a determined to be Kaeamhahr <br /> 11+11 proelleable and thor I ha•s seleued the p�raaieable method of tream,enl,rtaroga.of dlrpaeal eurrsnlly available to en.�h+ch�*inimixes rfie pretsnr end futu•.ilrreor to human Malrh <br /> and the en•iraemenr;OR,if I oto a srna"quamiry genetarorr r have made a good fauh effort to minimize my wo>,te generation and :elect+he bust waste ionagiment mslFod thal is <br /> owilable to me and rhal I can afford. <br /> � 5i nota, tb pay ysor <br /> >. Prinred/Typsd Name Z <br /> B O <br /> I ; 17. frons ar4r I A[Imo-1*d emanl of Recei t of Maleriats <br /> ii Prinnd/i Name Si atura Month Oxy 'loot <br /> 1 B. Trans orret:nslinowled eluent of Recel r of Mmar}ols <br /> U I s. from <br /> mloor Name Signature .Maruti Day Year <br /> w <br /> R <br /> V 19, Ditcreponcr'ndicatlGn Spon <br /> 7 p <br /> A <br /> C <br /> 70. Facility O.ner 1+1- ararer Carl! alfan f rano i rs1 hazard0 r ino4ndll Govern{!4t his mat+Ifelt eecq I.Is holed in 4ste 19 r _ <br /> Y {triose 7 ped N�e � Signa / ,_ � � I /ienll�r pey I (ear <br /> Y ` V LrF O 1143 <br /> DO NOT WRITE BELOW THIS LINE, <br /> DTSSC 8027A l4/97f :. <br />