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MAY.15.2002 10:49AM CAL/F'::q DTSC —
<br />HWMP NO.969 P.30i43
<br />Slate of {pgmmlo—inrfronmomal Protedlon Aaertcy
<br />form Approval OM5 No. 20so-m9 (tsplr■. 9.3496)
<br />Soo Instructions on back of page b. Department of Towk Subrtanc.t Cr
<br />PI~ print or grpu Form d.rpn.d !eq ere an "91" (129111h) tYF■ n�fe'.
<br />Sncramenta. CallFomla
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<br />1. Crnerniors US !PA 10 Na M,lnlf al Document No, 2. Pape 1
<br />Inlormallon In the Ihaded areas
<br />UNIFORM HA Z RDOUS
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<br />it not roqulred by Fedora= law.
<br />WASTE MA (FEST
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<br />D. Generator's Name and ailing Addrop
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<br />A. Generator's Phon■ ( t (209)942.5250
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<br />15, Sperlal Handllnd lootsat11 and Additional Informntlon
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<br />Emergency QaIzAi heads (800) 57676444
<br />Aevle 1A, 411140
<br />16. OENEAAT '■ . y doclarn that the contents of Ili s cram gnmonr are V y An occuralely described above by prop.r tHppino nom& and are closllPed,
<br />Upocked,
<br />madied, ova In all respoets In proper eondllion tar transport by highway According to oppfleablm hnarraffonal and nallandt goveh,ment ropufallar,s.
<br />If I am a lorge quantity gar,ercrar, I cegllY ilia} I have a program In place to reduce the vdlo,ne and lowkRy of woom gannnosed in the degree I hove determined to be
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<br />sconamleally proolcahle and that I hove ulacmd the practicable
<br />molhod of aeetment, slarage, or dl.patal eurrenlly ovallabin to me which minimlxos Jho prowro and future
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<br />threat In human healift and the envlrcrvs:eM, OR, If I am a small quantity generator. I fie.. made a good falth effort to minlmite my walla gonarotion and select iho belt
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<br />waste mono emeni moth d that y avollablo I* Ins and that I can
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<br />17. Tegn',porter 1 Aeknnwlooloment of Retel 1 of Maltdols
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<br />DO NOT WRITE
<br />DTSC 6022A (1/93)
<br />EPA 6700-42
<br />THIS LMR,
<br />Whrfar TSDF SENDS THIS COPY TQ DTSC WITHIN 30 PAYS,
<br />Tar N.C. tiay 3000, Sacromanlo, CA 41812
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