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r Store o(. rntEnittonroiYiol Protection Agency <br /> ' For000 `00039(Expires 9-30.99) See Instructions on back of je 6. Department of Toxic Substances Control <br /> Please prtftt;or I f p F$1At dii7 ned kr use'on elite(J2-per.itch, trit <br /> Sacramento,California <br /> �UNIFORHAZAROOUS 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 I Information in the shaded areas <br /> is not required by Federal law. <br /> WAST `MMOST of <br /> i <br /> 3. Generator's Name and Mailing Address A <br /> kStaNlrf4�rt D�be:umenf Number ' <br /> 41O's 05tpp Industrial Spray 22 <br /> 0 1140 -1 Blllilesemer Rd. Attn: Nancy Bennett B. State G heratoelID <br /> V) .)'.'JpAPh.QiR 953}37 <br /> 109 <br /> CV 5. Transporter 1 Company Name 6. US EPA ID Number C. State ransporter's s rved.] <br /> W) <br /> ao <br /> 0 D. Transpotter'b.Phone <br /> o ONE EARTH ENVIRONMENTAL INC CI A RI 01 01 01 01 01 31 7 - <br /> �00 7. Transporter 2 Company Name 8. US EPA ID Number E. State Tronspmer s ID(Res .j ` <br /> 0 F. Transporter's Phone <br /> Ln a <br /> OU 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID, <br /> Q Pacific Resourae Recovery Services <br /> �Z 3150 Eaet Pico Boulevard H. Facility's Phone <br /> NO Los Angeles, CA 90023C Di 0 "1 8 2 5 2 4 0 (800)499-7145 <br /> J 12. Containers 13, Total 14. Unit <br /> 11 <br /> NU . US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No. Type Quantity Wt/Vol I. Waste Number <br /> °' HASTE FLA144ABLE LIQUID N.O.S. (ACETONE) , 3, :212 <br /> 3 G UN1993, PGIII , EPA/Other c00 <br /> !1 DIM G D001 F003 <br /> o N b. State <br /> OD <br /> 00E EPA/Other <br /> v R <br /> f v A <br /> o <br /> state <br /> T <br /> R EPA/Other <br /> R <br /> LU d. State <br /> j Z <br /> U EhA/Other <br /> LU <br /> N ti';Addlid no Desc(tptiontfor Materials Listed Above K. Handling Codes for Wastes Listed Above <br /> f Z <br /> � - 55GAL WPRIO# 20070197 ERG# 128 b. <br /> V) n ., <br /> LU <br /> c, <br /> d. <br /> IIIp�86�dllnsr�,� 4iJi°�.dllLa°CL: <br />� 0 5/a"uY <br /> z One Earth Env. Inc./Ruben Chavez 831.637.8509 <br /> w <br /> t 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, <br />�LL U marked;and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> t. If 1 om 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 economically <br /> j to 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, if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> Oavailable to me and that I can afford. <br /> } Pr' WIT pod Name Signature Month Da Year <br /> Z h V� h k ..� D 4 <br /> I Z5T 17. Transporter 1 Acknow ed ement of Receipt of Materials <br /> A <br /> w p Pr• y Nome s Signature Month Day Year <br /> Uj <br /> i t+ 0 18. Transporter 2 Acknowledgement of Recei t of Materials -- <br /> j 1 Printed/Typed Name Signature Month Day Year <br /> LIJ <br /> f V) It <br /> R <br /> U19. Discrepancy Indication Space <br /> F <br /> l A <br /> C <br /> 1 <br /> I L <br /> 1 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> I T Printed/Typed Name Signature Month Day Year <br /> i <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A(1/99) Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> ' EPA 8700-22 To: P.O. Box 400, Sacramento, CA 95812-0400 <br /> i <br /> i <br />