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91ara 6LGalilWnte--liaijth and Wejfue Aaency Deportment o1 Haailh Servjces <br /> ivision <br /> F xpt�RPf 0}A9 No.20bd—a03F fE+pkes 8.30.01) f Toxic Substances Control CaliforniaPlease bA aK9 lypg. (Fara designed for seas d.1 sgfa(12-pitch fypewrllod le <br /> .d� Sacramento, lifornle <br /> YNIFQRM A RQOU� 1 gensrpor4 U8 PP {o. oMt�Siai I 2•'P4ga 1 Inform0on In Me shaded areas <br /> WAST MANIFEST Pl Is no;rgqulrsd by Federal law. <br /> 3:gpttprator'a Name and 141.f ng Addrsee <br /> y 4 <br /> r <br /> NElYT p a 6di1 p� <br /> 1 e. Gnaral,rY none f Iry � <br /> 3 5.Tran}portar 1 Company Name f). " E)1 EPA ID N!m0or <br /> Ral a eK• <br /> 7 4 p' ra <br /> 117 <br /> 1 !a.Damp glad Facility Name and SBs Address to, ISS EPA ID Nurepe( yy •:ri 3 <br /> i <br /> CM (F WMMIA <br /> l <br /> �.; <br /> r'a 11.V3 DDT Description(Including Proper Shipping Name.Hazard Class,grid 4)Numbs$) Quantity Unit - tlyaalg <br /> No. Type WI/Vol <br /> i <br /> 81gta. .- ,T•.- � <br /> e: <br /> �gF�ar+ CALIFOMIA .A� !E OMNI- P RCM <br /> EP JpIy.. <br /> cow R b. Sial <br /> r~ <br /> A FPIIRhFF„ <br /> T <br /> a D state <br /> i' <br /> F d. <br /> �r: 9 p119i11 for Mal@rlllle Pallhl <br /> tpr,�ax¢gpai��. ..- ���N�ppkj1 -�i `b y.h , c �r ✓•1;�tL r �� r:' <br /> c 0 s 4t r <br /> Lls. Tr' 3`N�Yn "7 ��~ d!'rr�.;h 5• l.' }�k Sri , r�ri t>S1, rwr ! <br /> Xt <br /> �7 .,.4..:i ? ,rf�r_, .,..n,a r_C.�'4...Y:•�k >i;, Y•. F .,�.. !.,s r:�irFY.7�.. �r�,:.�iL;S rn{t'����ih�6^tiG,.•�;. ';)•. ._�` � ' <br /> 15.Special hlsndling Instrirdlons and Addlilonal Inlarmatlon <br /> i fl Fed GIBSMMT We aw <br /> 'j OEIIERATOR'S CERTIFICATION: 1 hereby declare that the contents of this eonal0nmeni are fully and accuralaiy described ebovo by proper shipping some <br /> end are classified.pecked,marked,and labeled,and ars In all respects In proper condition for transport by hlghvfay according to applicable International and <br /> national government regufalfons. <br /> If I+un a targe quanllly generator,I cattily that I have a pfogram In place to reduce the voium6 and toxicity of waste 09nilly available <br /> to the degree I have determined <br /> he <br /> to be economically practicable and that I have ielecled the practicable method of tesalmenl,storage,W disposal curler <br /> available to ms whish minlmlzas the <br /> •p(p:onl and!inure threat to human health and the envhoira".OR,f1 I am a amatl quantity generator,I have mad_e a good fallh effort to minimize my waste <br /> generation and select the beat waste manapamanl method that is available to me pn�that I can afford. _ <br /> i <br /> Month Day Year <br /> prialedrTyped Yams <br /> - T ,T,Transporter 1 Acknowledgement of Receipt of Materials <br /> 8 Signature Month Day Year <br /> '4 A N <br /> PdntedlTyped Name <br /> P <br /> § W 0 14.Transporter 7 Acknowledgement of Receipt of Materials <br /> Month DtrY Year <br /> TPrintodrTYped Name 81grNture <br /> E 1 <br /> !' + 10.Discrepancy Indication Space <br /> F <br /> 1 <br /> ( 1 20.Faaglty owsar or Operator Cerilncatloa of receipt of hazardous matedalg covered by We mantras[except as noted In Item 18. <br /> t -- y PrinlIdlTyped Hama Signature Month D+y year <br /> gi @022 (trggj Do Not Write Below This Line <br /> EPA 0700--22 . <br /> (thy:4-84)Prr&vbu4 edltlons see obsolete .._....._.... <br /> YELLOW: GENERATOR RETAINS <br />