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<br />PAGE 02
<br />12/03/2003
<br />15:19 916-3815 .6
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<br />20. Foell: Owner or Operator C
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<br />6, US EPA ID Number ill
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<br />I �a•, INC 10. LIS EPn ID Number
<br />N2 6000 f3STH STR
<br />No $�iCRfaMENTO 9:,828 CA0000084517
<br />[VU 11. US DOT Description litulud�r Shipping Pro
<br />p Name, Nocard Clow, and ID Numb&
<br />WASTE PAINT RELATED MATERIAL, 3, UN126' ,
<br />3 PC- I I, (ERG#l128 7. 2#t/GAL (FOGS, F4i�3J D0t71,,
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<br />16. GENERATOR'S CERTIFICATION: I horeby declore Phot th. contents of Ihis conslpnLyM are fully and occurobly descrIbad above by prop., 16ipping name and are clas,ifiad, packed,
<br />j marked, and loh.led, and era in alI r0spacts in prop■, candltion for transport by highway according to opPlicoble inrgnallonal and national go rr menl raeubt om.
<br />e If I am a large quanti gen.roter, I crtify that I hove a Program in place to reduca +m voiumn and tonicity of waste gen.ratad to Iho degas- I have determined to ha oconomicoll
<br />practicable and that I I ase swleetod the rocticable mnlhod of rraarmrnr, storage, ar dispmal eurramly araihble to me which minimiaesent
<br />r fhe prand Future throat to human health
<br />and fhe arwironmant, OR, If I am o small quantity generator, I hove modo o good faith effort to minimize my waste generation and sabot the best waste manag.ment method that 1.
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<br />oroilably to car and that I can afford.
<br />rad/TypadYlo Signarur. Month Day Year
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<br />M-PS-1to Jaws mm�,er' o .07
<br />T 17. Trqp4A@r 1 klmawledgement of R I 1 of Materiols
<br />A Print %T Nam! Signet. -Month Day Y.sr
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<br />RITE
<br />L 8022A 11/991
<br />, 0700-22
<br />Month Day
<br />While- T.S.nF SEN05 THIS COPY TO DTSC WITHIN 30 0AY5.
<br />To: P.Q. Sox 3000, Sorramcnrr,, CA 95817
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<br />1 VTrcnpQw 2 Acknowfed
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<br />Printod/Typed Nam¢
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<br />19. Discropaner Indication Spaee
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<br />20. Foell: Owner or Operator C
<br />RITE
<br />L 8022A 11/991
<br />, 0700-22
<br />Month Day
<br />While- T.S.nF SEN05 THIS COPY TO DTSC WITHIN 30 0AY5.
<br />To: P.Q. Sox 3000, Sorramcnrr,, CA 95817
<br />
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