77Hwa.
<br /> k-aleaNiiand Wekan Apanoy i' + 7 ti }lr
<br /> (Ekpfreand s3 ^ s t,.
<br /> OMi�No.r20Sp�-bil3g �s i f See Instructions bn B8 -)gage 6'. _%Department ot Heakh`8onrl�el
<br /> a . Orm
<br /> d;;/9 use On sura c1,ry,,airrrrer), wand Front 6(P F Toxic Substances Control Divisio.
<br /> r s a `{+ 5 Sacramento Calitoml+.
<br /> UNIFORM :HAZARDOUS 1, Generator s US EPA rA No ManMeaf " l 2+ Pape 1,
<br /> F"atlo;n In the shaded areas is
<br /> WA3�` MAN�FES1`' ocu nt No''»
<br /> S Galti9►6tor'a Nlthe dnd Melling Address` r
<br /> of ', tre quired by Federal law.
<br /> • 4 } �t'd ' ru8hf6MantfifilDou�iaf►
<br /> ' `s; r a itlkberti►tyttoi;liltf '' 7 w
<br /> t ti. Transporte�,�i Com «
<br /> a S „ PY'Na US EPA ID{Number
<br /> 9.GpanY Y B 8+ pA.yr� umber i by t i a ,.tris Ytllf+il,
<br /> ng
<br /> �. 0. D signated ellity Nims a 8 sa P y a
<br /> } * s.tw 1 + . be 1 s tht.
<br /> Air
<br /> it V 64 jivou
<br /> 11 Us WT DssetlP�t( fi1 ro t hf i` a 12s ContalAeta rt 99+.rola! w 14°
<br /> �. ! +� Pp�!fi lamb,°' Ie�ard CIAbs and Ib Number) ; f'i Quanti `
<br /> No:" ty, Unit . >: Waiafio
<br /> a �y I WVVol
<br /> Sta
<br /> m
<br /> 71
<br /> AIR
<br /> t ,
<br /> o ,
<br /> \ r 9
<br />•,t'4 f� _.,•,,rfI .�' t
<br /> t 7
<br /> r
<br /> 4
<br /> + � i
<br /> i 4 t 440
<br /> Ca.
<br /> atsP .. �nlinO,IMtructlWi
<br />�lrY� .i t -.� �.a r,;. �' �l..r'�`i JS�, s' 1 � y S.w. ..�.. '� ,I - -r � fi n� *,� �•.
<br /> « and�a �8�.MVICAVf6 7Jt hsteby dA64 tha the contants of fhib oonsfpnm8^t era luny add"acc6ratef�tieadrlbed"6bbve by Prop ehippinp iiemet a
<br /> F t t r p t>ittfd,tliaHced,and labeled;and an to all rasp
<br /> we In proper condition fol frena ort.b hl Five a
<br /> .' 1 haf(dMN Ge�arAl�ilnt, � . . s va L -� � ?-P.' .-. ..tiP._,Y 6. Ys; Qrd 5lnterllat�orlalland3 s..
<br /> a " Y tom ntfN tor;l." fhat.i�Ava a pro0rarh iri'plac to ieduce the voQ"and to�lclfY ot:waete peseta ed 10 tfi6'd ►ee 1 Riva d�t`4 n G,"
<br /> e0 a ermhed ,
<br /> O pY Pra afid t K3vU t+eltlotad the dlicticabIs method of.lreAiMent,etola0e+rot dlepotif currency.avellable t0'me whicf►lhinfmis€os the ''
<br /> , ,y+' ffrasanf and•tutute tfvSAt`!o human Wifth and the:eavlromh ti;btt;,if l cm`a emalf'"uenth
<br /> f( + � ener o,I have aiada,arpood.fahh effort to minimize my waste Y
<br /> paabMKoa and elect th�;bdat'waattrme^tfpaineht method that Is a�iallahle toLme end.that I can M n
<br /> j' ..
<br /> ro t µdid Name*- '4x';3
<br /> Signs
<br /> e,',- a $ . w Monts Day Year , >
<br /> �. to ,R .17. ,reneportat 1 nowt emeid of Receipt of Materials
<br /> A< PN^tedlTypsd ams, t +'r , BI natu _�
<br /> t N¢•m +t.,�p l Y. r,.... .•r skrM• .-..J+.Mklnn,0 •'W+ V /nVIIr!'^-YaY".w•Y
<br /> P r
<br /> b uia - e pdm t Of Reoet rr •.
<br /> I 'Matarlali;^ k
<br /> R. Printed/ erne r a +
<br /> T r lr•r SlOnatun t Da Year.
<br /> I # ,E + 1.4�. tr x 1 Monts 7 Y
<br /> 10j
<br /> •� � 1,J } �•f x..� s k'L is i3-'"a� Y �*;i1
<br />�y 1 'A 5 +wY-....+ i �.i.....w..-a:,y..MA +r+.�",..w..t.'� _.+ac+rt ,. - - _" - ;4•
<br /> 1 P Y Y r „ r�
<br /> T, 20. Facility�OMmar•Or ,opbratpr CarlKlcatWn of tsosi t of hYza tills meteHale oovAred b rth f rfiAnlfesf exogpt;ae.hotedJn,tfem.ita "h,k *;1
<br /> t« r {
<br />�x a Printed/7y0 a 7 tq . ^ Signature-,. W
<br /> 9 a Month,. r;
<br /> 8022 A -. . « .. _. . .:
<br /> w
<br /> EPSefo2 C1, Not Wrl�`e how 7hisfune
<br /> o=a
<br />{ (Rev.• -09)Pravfoua edHIMA and Ob 6.
<br /> ;oR r+ ;IGEN
<br /> �� r ,Yellowy TSDF SENDS THIS tGPY TO GENERATWIfHIN'30 DAYS c'
<br /> as .�
<br />[ p.. .., 1 k qfl, �.. FJ•°.,da, ` f f ,� i a•
<br /> . ,. .':w..,° a ...,i' r.+ !^ ,. .. ,tt ate. r:.;..:..4: 'S3!:,<5,+ ,+ �,. , ..•J?' ;, sR.r } i..S'"z- ate- .f..;+"i •&.,k1 ,°� •'"..�5''.,S,L •
<br />
|