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.02/18/.04 WED 08:17 FAX 559 58P -l31 CHEM WASTE MGMT, KHF 160,04. <br /> Stowe eF Calilwnia,—E ironmonwl Protection Agency n •• <br /> Form Approved OMB No.2050 0039 IE�rpires 9-3Q991 Seel ructions on bOCIC O� �e 6. Dapanmonl of'Toecic S�b=tonc��onrroi <br /> Plaase print or typo, Foran designed For use an elite 112-pitch)"cp iter. . . Socromento,California <br /> •—� • 1. Generotars US EPA ID No:. 'Monlfest Document Na. 2. Page 7 Information in ttno shaded ar"eas <br /> UNIFORM HAZARDOUS is not required by Federal <br /> WASTE MANIFEST•. ICIAIR16 16 10 16 15 a 9 7 12 1 1 <br /> of y <br /> 3. Generator's Name and Mailing Address A State Manifest Document Number <br /> H J HEINZ CO 'LP 2 2'0 15 6 0 3 <br /> 2800 S CALIFORNIA ST • 6_ SlaleGerwatorsID <br /> STgCKTON ' -CA 95206-3242 .... <br /> 'sr7 4. enemtor s Phone( •.' .. . . . . <br /> .1� 5102568-2626 .. <br /> 5. Transporter 1 Company Names d. US EPA ID Number C.51a1ens <br /> Traporter s 1D Reeened.] <br /> .: .. <br /> D.Tranaporices Phone <br /> 2 L` zd g y <br /> W •7. Transporter 2 Company Norms ,8_ US FPA ID Number E.State Transporter's ID[ esorv%:d.l . <br /> F.Troneporter's Phone. <br /> a <br /> U G. Stole Facili s ID <br /> 9" Designated Facility Nortre and Site Address� 10:US EPA ID Nuedxr y <br /> �Q <br /> CHEMICAL UAS TE MANAGEMENT. INC. r <br /> jo 35251-01,D SKYLINE ROAD . H. Facility*P6one (209)386-9711 <br /> W <br /> KETTLEMAN .CITY CA 93239 ' CAT 0 0 0 6 4 6 1 1 7 <br /> 12 Containers 13. Total ld- Unit <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Cion,and 1D Number! No" Type duonfily WI/Vol 1. Waste Number <br /> a• NON RCRRA HAZA RDOU55 WA$$T 5I.D,. slate 181 352 . <br /> . (TREATED 1100B CONTAMINATE T TiH ' <br /> ARSENIC AND CHROMIUM) I O 6 EPA/otlrar. <br /> •N b. State, <br /> o E <br /> NR EPA/Other' <br /> v A <br /> C. <br /> .. :. State <br /> o T. <br /> ao O <br /> R EPA/Other•.ar- <br /> -• <br /> w d Stale'. <br /> r <br /> Z <br /> U EPA/ <br /> ;, Olher' <br /> LU <br /> Us J. ddirional Deseriplio a(or Moterlals listed Above r K Handling Codes for WVwlee Listed Above <br /> O a. EC0340 f�N -.' (� b. <br /> V) <br /> �. . <br /> ce <br /> C. d. <br /> O15. Spoclol Monrlling Indrvdions and Additional Information• ., <br /> a CHEMTREC.Emergency. Response. .Nufiiber '..(800 7424-.93.00 W.MT 'Contract <br /> Z <br /> Q16_. GENERATOR'S CERTIRCATION: I hereby declare[hot Ike contents 41his eoni�gr�mort are fully and accurately described above by proper ship ing name orad are classified,packed, <br /> 1J marked,and labeled,and ore in all respects in proper condition for Irmuport by highray according to applievbb fnlema6onal and nation o�govemmcnt rogulallons. <br /> If 1 am a levee quonliy generalor,I cerllFy that I Moya e p rom In Aldan b reduce the'eltmne and loxidty of.Waste genavated b the degree 1 hove dalerminad:to be eeon rnk-il <br /> practicable and that I hone sekcad the�raceicable method of treatment;slarnge,or disposal a Kranll�amilable Io the yvitleh minimizes the prebrnt and future threat to human heahh <br /> and the rnyirontnent;OR,if I am o smoll qua lity gene�oltsr.I have made a good faith effort oo minimize my Waste generation and solea the best waste monogement method that is <br /> O o ' me and that I.can.afford. <br /> . . <br /> > Print /Ty ed ame crave Mondn Day Year <br /> Z. d G <br /> ty T ' <br /> Uj p 17. Trb s orlar 1 Ac emenf of Recci t of Materials' <br /> LU PPrinted/Typed Nome Signature' Month Day Year <br /> . �.� ( l ` d s 3 3 <br /> 0 IS. rone orler 2 Aekno.vled omen)of Reeei 1 of Moleriols <br /> TPrinted/Typed Nome Signaturo M«Ilh 'Doy Year <br /> LU <br /> E <br /> 9 <br /> UF' 19'- Discrepancy Indication Space <br /> A . <br /> L <br /> .l • 20. Foclil Owner or O orator Certification of rocei i of hazardous materials covered this manitost G=pt as noted In Item 19, <br /> T' Pr; a /Typed Name Sllooluro Month t� Year <br /> 1' <br /> DO NOT.W 'BELOW THIS, LINE: . OV <br /> DTSC 8022A(1199)• •`+d's:' T5f:i, iudCS 'Hip CC:F'Y TO.D75til7r! SC'D.a"-• . . <br /> EPA 8700-22 <br /> OC. Sx+c,mrr.tc. .C� qsc.,_ <br /> c t? <br />