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State of rota—Environmental Protection Agan y F pproved OMB No.2050-0039(Expires 9-3 -99) See Instructions on back of page 6. Department of toxic Substances control f Please print`gr type. Form.designed for use on alit [12-pikhl typewriter. Sacramento,California UNtF,bRM HAZARDOUS P- 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas C A? . a00 W`•`.4 0' ('`✓05�.'6 1 is nor required by Federal law. WASTE MANIFEST of 3. _Generator's Name and Mailing Addr ss kJ><3..S " %; Z:1:�..i_ A. State Manifest Document Number k rt Lt ;d�1); 5C35+r7 3'�JLI, �El?C,'t)i'•I 23514713 {•{A1110i•� _rte CA '-y+'x5B:'-'!—•0Lr';>r5 B. State Generator's ID u7 4. Generator's Phone( 20 q 1f•_t 4-401 4 Y• r -f1 0 0 j�G> n NLo 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID[Reserved.] W `)F4�•ET`:''-f'r LE.=kNI' SY, TEMS, Ir.,C T Q. )OJf5 4 7 :d D. Transporter's Phone 800 669•-5740 oD f 7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID[Reserved.] J Q F. Transporter's Phone I L- U ?Zs n e Fa'i a nd te.Ad .ass 10. US EPA ID Number G. State Facili 's ID 600C 88TH STREET � O SF4'..,iRA IENTO CA 95828 (,A0000084 51.7 H. Facility's Phone M w 916 386-4913 •`•�Q 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12• Containers 13. Total 14. Unit C\jU No. Type Quantity Wt/Vol I. Waste Number Z a f- State = HAZARDOUS WA TE, L_10'-11 D, N. 0. S. 'D`r` :r 134 H I�fA305'2 FIG T 1 I (x3039) (ERG#1 71 1 EPA/Other 3: G AQUEOUS BRAKE S LU ION(S. :#/GAI...," D039o N b' State 65 E N R EPA/Other v A o T c. state aao O R EPA/Other Fw- d. State Z w U EPA/Other - Lu N J. Additional Descriptions for Materials Lis- d Above K. Handling Codes for Wastes Listed Above Z Q 14 b. (/ w c. d. Q _ Z ional Inf m t�n 7-'' ,_r::! 1.L J'..;J::':r! t.S 4.r�!`.�4"i1JtJ;7 L3 vS 1.Ir4,,� iJ:.; "t• r.:: a SK ;'3(�'THOR I ZE€i TO RETAINLICENSED Sf B235EGUENT -11AP�IrR, AS NECESSARY. ZZ w A 63q �AlE: 2300 E S 111 L E RE: ST13CKTON J 16. GENERATOR'S CERTIFICATION: I here by declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,pocked, < marked,anddabele*,and`are in all re pects in proper condition For transport by highway according to applicable international and national government regulations. IF I am a large quantity generator,I certify that I have a proggram in place to reduce the volum�and toxici of waste generated Im the egree I have determined to be economically ha practicable and that I have selected th practicable method aF treatment,storage,or disposes £urrently ova able to me which minimize the present gnd future threat to human health h and the environment;OR,if I am a sm II quantity generator,I have made a good faith of rt to minimize y waste generation and lett the best waste management method that is available to me and that I can afford. ! 0 F } Pri tted/T P `ed Name 1 Signature Month Day Year I uj (,) T 17. Transporter 1 Acknowledgement of Rec i t affMateiials -�-••'� R Lu A Printed/Typed Name Signature Month Day Year w s ytio�4 ..✓.�'3 -4 C-{<.. . .. ..r:..- -- - j __ v ? a.. S 'O. `r- P w 0 I8. Transporter 2 Acknowledgement of Rect i t of Materials 0 R Printed/Typed Name Signature Month Day Year Lu T V) E < R U 19. Discrepancy Indication Space ' Z F �^ A ! \ I L 1 20. FacilityOwner or Operator Certification off receipt of hazardous materials covefed b t 's m i st exce s noted i tem-fi . Y (Prin d Tyypldl�eL 1 Do ��ar �'DO NOT W BELOW THIS LINE. 2004 AUG.1 RE PMS sig Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. DTSC 8022A(1/99) (Generators who submit hazardous waste for transport out-of-state; ='v I •-8700-22 produce completed copy of this copy and send to DTSC within 30 days.) ENTERED