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State of California—Environmental Protection A9"c <br />Form Approved OMB No. 2050-0039 (Expires 9.30 99) <br />Please print or type. Form designed for use on elite (12 -pitch triter. <br />Z <br />S <br />rY <br />w <br />t - <br />Z <br />w <br />U <br />L. <br />w <br />Q <br />Z <br />O <br />Q <br />Z <br />Q <br />u <br />J <br />V) <br />O <br />Z <br />LU0 <br />2 <br />LUw <br />0 <br />LU <br />N <br />Q <br />u <br />VI <br />See Instructions on back c ge 6. Department of Toxic Substances Control <br />DO NOT WRITE BELOW THIS LINE <br />A 7Ae+� 60,1,, "'r # -4 <br />DTSC 8022A (1/99) <br />EPA 8700-22 Yellow: GENERATOR RETAINS <br />UNIFORM HAZARDOUS <br />1. Generator's US EPA ID No. Manifest Document No. <br />2. Page 1 <br />Information in the shaded areas <br />WASTE MANIFEST <br />is not required by Federal law, <br />r t t�, � <br />of I <br />3. Generator's Name and Mailing Addre s <br />A. State Manifest Document Number <br />UNION PAC,if �: R.AILi�C�M <br />f <br />10CATON <br />,y� <br />`�3 <br />8,13 FA51 OTH SIRFEl <br />$e . <br />B. State Generator's ID <br />�}� <br />r6� ei�tor s' Phone <br />C;�1 } 71{1() <br />4` <br />( <br />t ' "f <br />5. Transporter 1 Company Name <br />6. US EPA ID Number <br />C. State Transporter's ID [Reserved.] <br />'Y:i{�{��RY I NVIRONMU.NIAt "S <br />PVP :(..+ <br />D. Transporter', Phone <br />7. Transporter 2 Company Name <br />8. US EPA ID Number <br />E. State Transporter's ID [Reserved.] <br />F. Transporter', Phone <br />9. Designated Facility Name and Site Add ress <br />10. US EPA ID Number <br />G. State Facility's ID <br />:11f;M11�;1a'tiL. WA'10 E. MANAG14 I- <br />N I RJ I" I ! ! 1AAN I ACI 11 <br />6251 OLD SKY1 INE I',0A11 <br />H. Facility's Phone <br />ELM 1 0 A <br />k 4: II. I <br />22,' '1964 <br />1 1 , US DOT Description (including Proper hipping <br />Name, Hazard Class, and ID Number) <br />12. Containers 1 <br />13. Total <br />Quantity <br />14. Unit <br />Wt/Vol <br />I. Waste Number <br />No. <br />Type I <br />a. <br />State <br />, L)N It('I,'A FIAr'k?I E YU£4 WA.. ' <br />I E 1101.11D. (DIS`iOLW l.) AIR FLOTATION <br />EPA/Other <br />- <br />G <br />tif'10,C } <br />j <br />!^� 6 <br />e <br />-r- <br />i <br />! a <br />1 <br />��_. <br />E <br />N <br />b. <br />State <br />E <br />R <br />EPA/Other <br />T <br />C. <br />State <br />O <br />R <br />EPA/Other <br />d. <br />State <br />EPA/Other <br />J. Additional Descriptions for Materials Liste <br />I Above <br />K. Handling Codes for Wastes <br />Listed Above <br />a. <br />b. <br />c. <br />d- <br />15. Special Handling Instructions and Additi <br />nal Information <br />EMERGENCY RGE:NCY CONTACT �GHFWRI C; 1.800-424-43W <br />NAE RG # 11A 171 <br />M I l,fFP .-. o e- ()0 z_ <I Q J I <br />16. ENERATOR'S CERTIFICATION: I here <br />labeled, in <br />declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, <br />in for transport by highway according to applicable international and national regulations. <br />arked, and and are all res <br />ects proper condition government <br />If I am a large quantity generator, I cer <br />practicable and that ftave selected the <br />ify that I have a pro ram in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br />racticable method a treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health <br />and the environment; OR, if I am a sma <br />I 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 can afford. <br />Printed/Typed Na a- i"-•., <br />Signature <br />tMontl1 Day., .Year <br />T <br />17. Transporter 1 Acknowledgement of Recei <br />at of Materials <br />R <br />A <br />Printed/Typed Nams -1 / i <br />1. <br />' •i` <br />Signature <br />�Aontl` Day Year <br />I° ff ��� <br />s�rl} <br />D18. <br />Transporter 2 Acknowledgement of Recei <br />t of Materials <br />TPrinted/Typed <br />Name <br />Signature <br />Month Day Year <br />E <br />R <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />I <br />L <br />1 <br />20, FacilityOwner or Operator Certification <br />f recei t of hazardous materials covered by this manifest except as noted in Item 19. <br />T <br />Printed/Typed Name <br />Signature <br />Month Day Year <br />Y <br />' <br />DO NOT WRITE BELOW THIS LINE <br />A 7Ae+� 60,1,, "'r # -4 <br />DTSC 8022A (1/99) <br />EPA 8700-22 Yellow: GENERATOR RETAINS <br />