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State'af Colifomla—Envlronmantnl ProtectionAgency - - - <br /> Fprm4pprdved OMB No.2050-0039(Expires 9.30.96) See Instructions On back of page 6. Department of Toxic Substances Control <br /> 1 -Please print or type. Form designed for use on efile(12pfkh)lypewriter. - - - Sacramento,California <br /> UNIFORM HAZARDOUS Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas' <br /> is not required by Federal law. <br /> �AV')Bij <br /> WASTE MANIFEST613� of <br /> - 3. Generators Name and Mailing Address <br /> Szbc.�c IoW V u 1 I SCHQo L D/5kV/ C ' <br /> in <br /> 194.4 u. CL �>W L TQ6 '570c. 0&4l CVA C1 0 <br /> Ln A. Goneraror's Phone <br /> 5. Transporter 1 Company-Name 6. US EPA ID Number <br /> J . Transporter 2 Company Name 8. U PA ID Number <br /> ou <br /> 9. n Facih'r�r Name and Site Address 10. US EPA ID Number <br /> 1::� 1CIC:SCI�L.JItC. <br /> e-�0 255 Parr Blvd. <br /> a R.iCuTr,>rld,CA. 94801 C A G 0 0 9 4 6 6 3 9 2 <br /> U <br /> 11. US DOT Description(including proper Shipping Name,Hazard Class,and ID Number) Containers 13. Total 14. Unit <br /> � NO. T Quantity Wt/Vol <br /> s= 13-NON-RMA. Hazardous Waste Solid <br /> =i G Waste Dr-ty Storage Tate:. - T P 1 <br /> E <br /> = v E b <br /> � R <br /> =a A <br /> - T C. <br /> coO <br /> w R <br /> Z d. <br /> LU <br /> U <br /> U) „. <br /> 0 15. Special Handling Instructions and Additional Information <br /> a Keep away fzom sc*wces of irj1At.i" -t, Always weal- hart--hat-S. wher-i wpl-kirvi rxrould <br /> Z CT.G,5.''. 's 24 Fir , C;Yitac.#: <br /> LU <br /> 16. GENERATOR'S CERTIFICATION: l hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> packed,marked,and labeled,and are in all respech in proper condition For transport by highway according to applicable international and national government regulations. <br /> U <br /> WIt 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 have determined to be <br /> a economically practicable and that I how selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future <br /> t) threat to human health and the environment; OR,if I am a small quantity generator,I have made a good faith effort to minimize my waste genera6nn and select the best <br /> waste management method that is available to me and that I can afford, <br /> O Printed/ ped Name Signator )II Manfh Day Year <br /> i u R 17. Tnraorter 1 Acknowled ement of Recei of Materials <br /> 0 A Pnnted/T d.]lama -- Signature TMonth Day Year <br /> 'i W S <br /> - � <br /> su 0 18. Trans orter 2_Acknowlecf`ement of Receipt of Materials <br /> me Signature Month Day Y <br /> R Printed/Typed No <br /> ear <br /> p E <br /> R <br /> Lu <br /> 19. Discrepancy Indication Space <br /> U F <br /> A <br /> Z C <br /> 1 <br /> L <br /> 20. Fa ility Owner or Operator Certification of receipt of hazardous materials covered 6 this manifest except as noted in Item 19. <br /> T Printed/Typed Nome Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> 0T5C 8022A (1/95) Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br />