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&ateilf Colifgsma Environmental'Protection Agency Form Approved OMB No.2650-0039(Expires 9-30-99) See Instructions on back Of 6. Department of Toxic Substances Control f lease print or-type Form designed for use on elite(12-pitch)F, to Sacramento,California UNIFORM HAZARDOUS I. Generators A ID No. Manifest Document No. 2. Page 1 Information in the shaded areas' is not required by Federal law. WASTE MANIFEST V1 Al 01 91 81016517151 12181 Q, I 'A 1 7 1 ' ' of 3. Generator's Name and Mailing Address A. State Manifest Document Number ar H.J.- Heinz Coffipany 2 2_`3 � '...- PO Bc. 57;Stockton,,ckton, CAA 95201 B. State.Generator's ID 4. Generator's Phone.( 209). 932-5752 Pel (" T1 I R 1 C.'..G CV 5. Transporter 1 Company Name 6. US EPA 1D Number C. State Transporter's Reserved.] 0' D. Transporter' hone. o Deli Oilfield Services 1� Via. ao. - - - 7.Transporter'2'Company Name 8. U5 EPA1D Number E State Transp rter's ID[Reserved.] �a E. Transporter's Phone`-" �U 9. Designated Facility Name and Site Address l 10. US EPA ID Num b�eer' G. State facility's ID �Z T,ardfill N81Z ko ( C�"l f ��^�t/r 1 lE. +" c, t', o .4 f is s aL H.,:Facility's Phone 510 . 61426 Hay Road \�JJ ��{{-- 7 dQ ; ► c� CAI? 961 ' O42475 70714.51-327" + 1 1. US DOT Description(including Proper Shipping Name;Hazard Class,and ID Number] 12. Containers 13.Total 4. 'Unit �U - - No. Type Quantity 'Wr/Voi 1 i. 'vvasre number. Z a. . - State RQLTbeSt{ , � .NA2Z12� PCI1T j�AFtt#171:� 'E r.,•3 3 O oil y!� EPA/Other C.N E b V L. is11 State o N 00 .00 E NR EPA/Other v A o T State a0o O R EPA/Other •LLJ d. State Z W (•) EPA/Other i W Z J.;Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above O o. b. In tr.\I.^—J3 . . . 03 W C. d 15. Special Handling Instructions and Additional Information Lc-T>F°` gevlc Phone" 530/662-284 O P • 1 .7Csb #4503 Z EPA. REGION IX: San Joaquin Valley APC' ; 4230 Kierrw) Ave. Ste 130; �b esto, CA 95356 SITE: 2 500 S California; SCA ASBESTOS POADVAL R_LURE 2, W 40 GFR 61 l 7 t ^;• r C'V a 1' 'r 1 vrrrnA 9 1 b. GENERAT 'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, VI� marked,and labeled,and are in all,respects in proper ondition for transport by highway according to applicable interdational and national government regulations. d If l ani a large quantify generator,l certify that I have a program in place to-reduce the volume and toxicity of w e generated to the degree I have determined to be economically a.. procticable•and that I have selected the practicable method of treatment,.storage,or disposal currently available to me which minimizes the present and Future threat to human health and the environment;OR,if I am a smaquantity generator,I have made a good faith effort to minimize my.waste generation and select the best waste management method that is O available to me and that I can afford. } Printed/Typed Name Signatur Month Day Year U r� w /��+�cs12.. ti y,� .€�-': r f! T it (7 T17:-Trans orter 1 Acknowled ement of Receipt of Materials i R W B Printed//Typed Name Signature/_ / Signature y- Month Day - Year —10 w P 4�} �r 3 1 Vv S—�8- i ^s=n•'_r �,Z�1511��- J W 018. Transporter 2 Acknowledgement of Receipt of Materials `T Printed/Typed Name Signature Month. Day Year W E Q R k. ., V 1,9. Discrepancy Indication Space F. I ff. Facili Owner.or erator ificati n of ecei t o hazardous materials co red 16Y ih i t r0qst e)ece t s noted' fern 19. Ji TPrinted/Ty d ame IVt Signatu nt ay ar DO NOT. ITE EB LO THIS LINE. - Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. DTSC 8022A(1/99) (Generators who submit hazardous waste for transport out-of-state, EPA 8700-22 ' J produce completed copy of this copy and send to DTSC within 30 days.)