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•02/18/04 WED 08:15 F.AX 559 38 31 CHEM WASTE MGMT KHF ^� 2002 <br /> skate ofCoU5rnia—Environmamalprotection Agency See Instructions on back of e'6. C�rt 1' <br /> Form Approved OMB No.2050-0039(Expires 9.30.99)' Po5 Department of Toxic 5ubstances n <br /> Please print or 1J1Qne.fa�rrdeslgrted far ase on stile tI2-gitcdt)type w or. sacrmnanlo,California <br /> S <br /> 1. Generatols US EPA ID No: Manifest Doetrmoni No. 2- Page 1Information in the shaded areas <br /> UNIFORM HAZARDOUS {snot required by Federal lour. <br /> WASTE MANIFEST R 0 0 10 10 15 19 19 12 12 °f 1 <br /> 3. Goneraror's Name and Mailing Address A: Stole Manifest Document Number . <br /> H' 'J HEINZ CO,-LP . 22015601 <br /> 2800 S CALIFORNIA ST B. StatoGeoerotorsID• <br /> ' S��CKTO�I CA .95206-3242 — <br /> tn rot«s Phone( 1 • <br /> 510' 566'-2626 <br /> CS! <br /> 5. Transponar 1 Company Name 6. US EPA ID Number C. Stale Transporter's ID IRezerved.] <br /> O, D. Tronsponar's Phone <br /> O - <br /> a? 7. Transporter 2'Compoay Nome 13. US EPA ID Number E. State Transporter's ID QPofqru.dj <br /> F. Traraporier's Phone <br /> 9. Designated Facility Name and Silo Address 10. US EPA ID Number G;State Fa Aly's ID <br /> a CHEiIICAL' WASTE MANAGEMENT, 'INC: <br /> me 35251 OLD SKYLINE ROAD H. Facility',Phone . <br /> o KETTLENAN CITY CA 93239 IC JA IT10 01016141611 11 17 (209)386-9711 <br /> •� 12- Cantoincrs 13. Total 14. Unit <br /> U <br /> 11. US DOT Description(including Proper Shipping Wase,hard doss,and ID Nuat6er) No. Type Quontity Wi/Vol I. Waste Number <br /> ? a• NO NN RCRA HAZARDOUS WASTE SOLID, state <br /> (TkEATED VOOD CONTAMINATED WITH I81 .352 <br /> G ARSENIC AND CHROMIUM) 1 � r � EPA/Other . .. <br /> E olop <br /> oN Is. State <br /> o E <br /> N R EPA/Other <br /> A e <br /> o T State <br /> ;s <br /> co O <br /> R EPA/other <br /> ac <br /> F d- slate <br /> Z <br /> t.0 <br /> t> EPA/Other <br /> LU <br /> sn J. dditiornal Desmpt o .for Materials umad Aba.e K Handling Codes for Wastes lined Above <br /> Z a EC0340 © b- <br /> LU <br /> d <br /> a <br /> 0 15. Special Handling Inslruclions and Additional Information <br /> a CHEMTREC.EITtereency Response Number (800)424-9300 KMI Contract <br /> Z <br /> w <br /> r <br /> <U 16, GENERATOR'S CERTIFICATION_ I hereby declare that the contents of this const nmmt are Fully and ocairNoly deserlbed above by proper shipping name and arc classified,pocked, <br /> UUUu marked,and 66.clad,and ore In all respeele;n proper eatdlt;en for tronspon�y h;�hway acre J;ng b applicable international and national government ragulotfons. <br /> —� <br /> IF I am a large quantity generator,1 certify that I have a program in place to reduce the volume and toxicity of vvasla gwaiated to the degree 1 have determined to bacconom[cally <br /> practicable and that I hove solaced the proNitable method of iraatmani,storage,air disposal anantly avo;1a6le to me which minimizes the present and Future threat te hvman.healt6 <br /> `n and the ervironmeni;OR,if I am o small quantity gernerafor,I have mode a good faith effort to minimize my wave gone nation and salon the beet..rile management method that Is <br /> O <br /> available to me and that I can afford. <br /> } Prinle typed N Sig Lure Month Day Year <br /> Z <br /> 1 LU <br /> 17. Trans orter i Ackn led mans of Receipt of Materials <br /> R <br /> W6 PrintadJTypad Nowa Signature Month D.y Year <br /> :�E R ✓ / O 3 <br /> LL, s <br /> P <br /> ss.. 0 18. Transporter 2 Acknowled omcnt of ksiceipl of Materials " <br /> A <br /> Printed/Typed ed Name Si noNrc <br /> W T yP g Month Day Year <br /> rn E <br /> d A <br /> V 19. Discrepancylndication Specs <br /> z F <br /> A <br /> 1 <br /> Z0. Facili Owner or O aralor Cenlflcollon of reset i of hazard..,moleriols eoverad Isy this monlfeo ez tot noted In Ilam 19. <br /> T ri lad/Typed Nome Signature Month Day Year <br /> Y = <br /> DO NOT . BELOW THIS LINE. <br /> DTSC 8022A I1/99). .. Vi4:-c. 15C,F ENP" 1HIS COPY TC UTSC <br /> EPA E700-22 <br />