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t <br />c <br />c <br />t <br />C <br />h <br />e <br />u <br />t - <br />C <br />L <br />n <br />v <br />C <br />L <br />Z <br />LL <br />C <br />tr <br />LLLL <br />LL <br />LL <br />C <br />LL <br />ou <br />State of California -Environmental Protection Agency <br />Form Approved OMB No. 2050-0039 (Expires 9.30.99) See Instructions on baCit Of P Department of Toxic Substances Control <br />Please print or type. Form designed for use on elite (12 -pitch ricer. c-—,,,- <br />DTSC 8022A (1/99) <br />EPA 8700-22 <br />DO NOT WRITE BELOW THIS LINE. <br />White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />To: P.O. Box 3000, Sacramento, CA 95812 <br />Generator's US EPA ID No. Manifest Document No. <br />UNIFORM HAZARDOUS <br />2. Page 1 <br />Information in the shoded areas <br />�1. <br />WASTE MANIFEST A 4 4 j <br />4 <br />e <br />is not required by Federal law. <br />I <br />of <br />tea M3 'sI j�ppse and Mailing Address <br />ftp <br />A. State Manifest Document Number <br />16300 West Road Tracv re <br />1 2342-28 4 4 <br />B. State Generator's ID <br />n <br />__ __ <br />4. Generator's Phone ( 209) R33-4941] SCO F f OLF <br />V <br />r) <br />5. Transporter 1 Company Nome 6. US EPA ID Number <br />C. State Transporter's ID (Reserved.] <br />Ecology Control industries 0 <br />D. Transporter's Phone <br />11112 <br />i 7. Transporter 2 Company Nome 8. US EPA ID Number <br />.E. State Transporter's ID [Reserved.] <br />J <br />J <br />F. Transporter s Phone <br />rY A9 91 SPS( Wk;aS.and Site Address 10. US EPA ID Number <br />uev eaceuuvee <br />G. State Facility's ID <br />Cucroce <br />2000 North Hiarrneda Street <br />H. Fociliit/s Phone 310-537.7i <br />10'`5_3fi Ou <br />t'",.ampton CA 9022; - - - - - - - - - <br />11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number <br />P ( 9 P PP 9 ( <br />12. Containers <br />13. Total td. Unit <br />No. <br />Type <br />Ouonrity Wt/Vol <br />I. Waste Number' - <br />ree <br />d a,i .r a ave ar e e v •" • u ae.wvv • er .a,.r a vsr_e�vv <br />'petroleum <br />0 <br />State '�y . <br />hydrocarbons,water} <br />�g �g <br />a i g <br />! - <br />�s. <br />G <br />e <br />EPA/Other <br />' <br />E <br />NONE <br />r. <br />) N <br />b. <br />.State - <br />i E <br />EPA/Other <br />r A <br />> T <br />t <br />state <br />i 0 <br />EPA/Other <br />R <br />I <br />d. <br />State <br />i <br />t <br />t <br />'EPA/Other. - <br />' <br />�,µµ��,,�,L[3,Scp <br />Oily water) . <br />I'�C)'PTtJfIi9 ifG.7�t�tfOf3Util�sl�ST1CTQ..� .. , <br />K. Handling Codes For Wastes listed Above <br />a b. <br />�C— <br />d <br />^r wedur::-a2rr �nvarnvimw4®. �d S.dnf�: <br />l.r.e.....e <br />emergency teiephone number t800j 321-54i9 (ECi Dispatcher). ECI A 5243085i <br />16. GENERATOR'S CERTIFICATION: i hereby declare that the contents of this consignment are Fully and occurotelr described above by proper shipping name and are classified, packed, <br />marked, and labeled, and ore in all respects in proper condition for transport y highway according to app stable international and nation. government regulations. <br />IF I am 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 />and that I have the disposal <br />practicable selected practicable method of treatment, storage, or currently available to me.which minimizes the present and future threat to human health <br />and the environment; OR, if I am o 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 />available to me and that I con afford. <br />Printed/Typed Nome 7�Signature <br />A as <br />A <br />Month Day Year <br />L-1 <br />T17. <br />R <br />iter 1 Ac led ement of Recei t of MateriAl <br />NPri <br />/T ped Nome a <br />Signotuie t <br />nt Day ear <br />S <br />P <br />!C <br />B <br />I ON Transporter 2 Acknowledgement of Receipt of Materiol <br />T <br />Printed/Typed a SignotureMonth Day Year <br />F <br />19. Discrepancy lnditati900NNTITYDISCREPANCY TER 0% Lj�yreJ yr-79ZA".d <br />C <br />WITH QENEERATTO'"R/TRANSPORTER <br />OF r.�iereu� MUMS <br />i. <br />( <br />20. Facility Owner or Operator Certificatior of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br />T <br />Y <br />Printed/Typed Name <br />�c/-.�/� G-'T� <br />Signature <br />Month Day Year <br />04-1 1 / 2 0 <br />DTSC 8022A (1/99) <br />EPA 8700-22 <br />DO NOT WRITE BELOW THIS LINE. <br />White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />To: P.O. Box 3000, Sacramento, CA 95812 <br />