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10/23/2003 15.25 4066839172 PTR:ADMIN PAGE 02 <br /> t . .V. NjY'I�Itlee Y3uvY)ylkP ' ase I/RSTr ons <br /> on DOCK o►PO. Dpomenlof Toxtc Subrbncet <br /> ConlrolPNv tt ,} M ' ePklbiA � Sacramento,California <br /> l <br /> ww a US PA ID•No. anifeil DecumeM No. 2. P.O. I Information in the eltaded areas <br /> — <br /> ,,.V HAZARDOUS a eat,oqu,rod by Federal law'. <br /> m'* 'STEO-MAttNFEST <br /> 2,.OelalAlor e:Herne and Mcilkall Addreu <br /> ' �. '•• •' '',r' ltotiti 1. 1. �;� �"►T-�..�. <br /> .�•:' ,rZ�'iTramporfe�'�•CdrjipanyNrnn _ '•;6:1iU�LIA ID.NumbeC' -. / ,, . <br /> oSi IEW CAU9S2413Z62' ' <br /> r 7 ' $hal l B. US EPA JID Nvmbw <br /> (we _ C14111f1 .B 5I: ' 1.919i � <br /> 9 'Dwifloatild Facility No—and SihiAddrps 10. US EPA 10 Nlfatber ri ;YN• �}� y <br /> '11. Crantolnen 13.'Tinel 14 Unit <br /> -:.Us DOT Description(including prdlW Sklpprng Nal Hazard C6",and ID Nvmberl No. T l9uoMi Wt/Vol 4Y <br /> TL <br /> i <br /> V. <br /> �,�[ <br /> Otee• a .• � .. .. ��,yq Atr! " J.1 <br /> •,�•'i. -••r. y. '• T, 1. ,.� <br /> Z <br /> •y ` S:S06,lJ`Hondling Inetruch—and Addi lonol IA{°rmation <br /> _�• .:• . •��+�. ��� � cx�rr.�crt�i;r>�� ��i��� ��� ice: <br /> I,& GENERATOR'S CERIIF1CATFON: I hereby dedwe Thal the eonleM:of Ihie cone natant ora fully and accurately dvecribed oboe by proper;hipping name and are elossiFred,pocked,. <br /> mwked,and labeled,and are in all aspects In pmpar cwtd.flon for frame �r highwoy according to applicable mrarnallonol and nationol government regulations. <br /> Wil. " . :..•• ., ' <br /> -••r 11 1 am o forge Quantity generator,I ertify Ohm 1 how a peagrve in place Io reduce?no volume and rox.c of-aloe gene,aled to the degree I hove determined o be oca ;colly <br /> ; ;i. plot+leabl.and that 1 hove wleded the Draetleolile method of peolmenl,Storage,or duporol cunenlly ova 61 to me whleh—Imizee ik.pr-am and future rhreal 1.human heobh <br /> and the envi,onmant,OR,if I am a sm.1 quantity g.nerater,1 hwe.made o,good farlh effort to mnirnize my waste genoroli—and resect rhe belt watts reonee.ment method 1h.1 1, <br /> available tome and that I can afford. <br /> }, y. .PSmMdIT. Oil Nome .j nGlut month Day Yew <br /> 17. Vail 'flew Irnowlad .mon+of Receipt of miilwialr <br /> a. <br /> DJ rltNed/Typed 'Slploluce f :'F' Month Day Year <br /> sL. •L'•1$:.1traas Ier2 Ack omenta at o Malerlolt • <br /> ` ed Noma <br /> Is.t ynaMrre Month Doy Year <br /> .LU IAJ <br /> pd <br /> ` <br /> 20.-T-acili nor or O omlor Certification -tete' 1 Of lta/M'ileus mohrialr cmr :b thii —nffwl- r m noted In item 19. <br /> T 1 + yped Name 1 :' $I$ n C.:. Monfh Day Year <br /> le eA2z 4-647' <br /> DO NOT WRITE.BELOW THIS LlE: <br /> LIM 8022A 11/991 <br /> EPA 8700--22 Green: TRANSPORTER RETAINS <br />