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of Colifor,AUG,24 '04 08:19AM HEINZ STOCKTON P.2
<br /> ba,.r
<br /> arm Approved OMB No,2060-0039(Expire:9.30.99) See Instructions on back of t rs, Department of Taxi;Su6sfonccs Co
<br /> Please prinit-ypn Form designed for use on okra fit-pdch) , 1�J ,0 1 Sacramento,California
<br /> UNIFORM HAZARDOUS I. Generator's US EPA ID No, Man;fcst Document No. 2. Page 1 Information;m the shaded areas
<br /> r'7 is not ra9uirad by Federal law.
<br /> WASTE MANIFEST
<br /> 3. Generator's Name and Moiling Address H J HEINZ A, State Manifest Document Number rj
<br /> 800 S CALIFORNIA 302399 ,'
<br /> . Q. 5OX 57
<br /> O B, State Generator's ID
<br /> TOKTO,NCA X35205
<br /> 4. cnrrotor s Phone 0 9 2 5 7 5 9
<br /> (N I 5, Tronaportar 1 Company Name G, US CPA ID Number C. State Trorsporter';ID(ajscrved.]
<br /> CP
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<br /> o° AFETY-KLEEN SYSTEMS, I14C T� ROQO 50 3 I D Tronspor+ar'sPhone
<br /> f) `;_ ,,"r1
<br /> 7. Transport Nomf.a8-Com y Noa . US EPA ID Numbe• E. State Tron:porle,s ID
<br /> f Q V" /`�G.�/' "tow, / F. Tran,portor's P ono
<br /> Y)V 9, Designated Facility Name and Sire Address O10. US EPA ID Number G. Slate Faclllly's ID
<br /> N4 Z SEE 119 BELOW 69 19
<br /> H. Foc;l;ty's Phone
<br /> _ .
<br /> emse(('•�U
<br /> 12. Cona;ne: 13. Total unit
<br /> 11, US 00T Dowi hon(including Proper Shipping Name,Hazard Class,and D Number)
<br /> No. T a Quant; Wt/Vol I. Waste Nvm6ar
<br /> Z a. State
<br /> _M NOW REGULATED LIQUID �
<br /> G 0 o12-1 ' ' t EPA/Olhar
<br /> NONE
<br /> Nb. C- State
<br /> REPA/Other
<br /> O T c' State
<br /> 0
<br /> m R I EPA/Other
<br /> LL, d.
<br /> State
<br /> F-
<br /> Z
<br /> LU EPA/01h9r
<br /> w �
<br /> Above K. Handling Codes far Wastes Listed Above
<br /> Z -J: Addd^Kanot Descriptions for Materials Listed Abv
<br /> . ' , . - _ _
<br /> �,....... � b:
<br /> y
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<br /> 0 15. Special Handling Instructions and Additional Information
<br /> MFST 1Z/T 104716415 0002--2481-68
<br /> z ME r"ZGE;NCY RESP 800-468-1760( 24 MR ) . IF UNDELIVERABLE RETURN TO GENERATOR,
<br /> LU . K CORP AUTHORIZED TO RETAIN LICENSED SUBSEQUENT CARRIERS AS NECESSARY.
<br /> s
<br /> G GENPRATOR'S CERTIFICATION: I hereby declare that the cbnra r.,o is consigrimanl are ul y ar. aewralelyy described obnva by proper shipP ing name en are<lassiked,packed,
<br /> marked,and labeled,and ern in all respects in proper condition for tron=rl by highway according Pa oppl;cable international and nationol government rcgulohons,
<br /> If I am a large quantity generator,I certify,that I have a program in place to reduce the volume and toxicity of wastR gcncroted to like degree I have determined to be economicolly
<br /> P_ prortscoblo and that I have se!ecled the Practicable method of rraetmanr,sbraea,ar disposal currently eve'lable to me which minimizes the prasvni anti future threat to human health
<br /> J) and Phe onviranment;OR,if I am a small quantity oancralor, I hove made a good faith effort to mimmize my waste aonorohon and selec!the beat waste management method that k
<br /> a available to me and that I con afford,
<br /> QPrinted p d Nome Si oturc Mo Da Ye
<br /> w T 17. orter 1 A;knowlad omcnl of Raeei t of Matenels
<br /> Z3
<br /> Lu p oto ped No
<br /> oar, , Ycc(
<br /> a �
<br /> u_ p Tr Acknowie awl r of Maha els
<br /> � R PrinraLt/ me /�,�/7 Signature
<br /> Vwi E /�.• � �j�e
<br /> V F 19. Dicrepancy In icolien Space ALT. SITE RE—DIRECT: U06113
<br /> �T�pp ppT'[tr��TT p�+rf�y�� T
<br /> Z A SA L'JL —KLEEN SYSTEMS,INC e-
<br /> C 1722 COOPER CREW RD., DEN'TON, T% 76208
<br /> L M1377603 65,124040)483-5200
<br /> 1 20. FQc;llry OwrLqC or Ciarotor Cert;fieatlon of receipt of ozordous molcrials covered by this manifest except C15 uglea in Itam 19.
<br /> T Printed/Typed Name Si nature i Month Day Ycr
<br /> Y
<br /> DO NOT WRITE BELOW HIS LINE,
<br /> P R,,�,,{�Q,L* A 0002208878 Whil, TsDf! 3CND$ �1-11S COPY TO DTSC WITHIN 30 OAVS,
<br /> SW;6'AA I qP 0 0 2 4 0 813 8 1'a: P.IP- Bax 3000, Sacramento, CA 95812
<br /> EPA 6700-27
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