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N^; 4, AZARDOUS WASTE MANI ;ST' <br /> Pieria print or p'r Foim designed for use on elfle 1a tch) rswdtery <br /> KION-HAZARDOUS 1.Generator's US EPA.IA No. Manifest��No. 2.Pog°i <br /> WASTE MANIFEST ev�77 °� <br /> ;i Uenerator's tbrne and Malang Address <br /> Fisoo Warehouse <br /> 16$8 Skala Road <br /> $-ockton, CA 95215 <br /> 4.Glanerator'sPhone(209 ) 467-1006 <br /> 6.Transporter 1 Corrgrarry Name 6. US EPA 10 Number A.State TrargmYlar's ID <br /> Advanced Chemical Transport CARD-00070540 a.TranspoAWIPhone408-548-50,19 <br /> 7.Trarsporlor 2 Company Name a. US EPA ID Number C.State Transpotter's ID <br /> M Transporter 2 Phone <br /> 9.Designated Fec fty Name and Silo Address 10- US EPA ID Number E.Sate FedfWa iD <br /> US Ecology Nevada, Int- DN'l'330010000 <br /> R.0 Box 67111, Hwy 95, 11 miles S- F.FacMty's Phone <br /> Beatty $Qq-&29-2942 <br /> psTE pE9 Trr D 0 12. Containers ' 7c� Unit <br /> No. Type Quantity NA.Not. <br /> a. <br /> Non Hazardouz Waste, solid (Soil Cuttings) � �� � 8 <br /> G b. <br /> E Non Hazardous tklawte, Liquid (8. ta.) P � G <br /> N <br /> 6 <br /> R C- <br /> A <br /> • <br /> AA10AJ 4AZ*Z4OUS 1J,+-'r-r4 L1 9 v1 Q <br /> T <br /> O <br /> 11.I d. <br /> I-, <br /> O.Additional Descriptions for Materials Listed Above H.Handling Codes for Wastes Listed Abow <br /> 0 <br /> I <br /> ■`e 16.Special kindling lnatruetlona anIpAddlilonal tr>f ion <br /> 07o120vs13-1z1 o �/ Q 0101,V741 A e <br /> FICI �- 1 f 2) �� Tlu <br /> 0 ,3 flu—�Il tcS �/r , <br /> z Project Number: C'VD0778 0701377VAsq' <br /> 16.09KIRRATOR'S CERTIFICATION.I herebqyy oarllty that the contents of this sldpmant are fully and asWrately described and are In all respects <br /> in proper oordhion for uanspori.The malerfst9 dmrlbed on this manifest are not subject io federal hazardous waste regulations. <br /> Date <br /> PrintedfFyped Name Signature Month Day Year <br /> ekGGGa C' M&W i ieei <br /> T 17.Transporter 1 AdawMllcipmard o1 Reoelpt of Materials Date <br /> APrin ved tl.ma Sijpr Monih Day Year <br /> 4' Q� <br /> /Z I a-61 <br /> pq la Tronsportar2 AdmovRodgamord of Receipt of MaiBdalt Dela <br /> T Prlydedftypsd Karns Signature Mon6r Bay Year <br /> AR <br /> F <br /> 1V.DISCMpanoy lndludlen Space <br /> A <br /> C <br /> 1 20.FaclRy Owner or Oparotor;Certiffostioh of teceipt of the waste materiels severed by this mansest,except as noted in Rem 19. <br /> L Date <br /> Namg Sign1yL., MpnNr flay Year <br /> Y I <br /> �rrreriaaeRerwrard[n <br /> CF14 02002 a taoo1827.6 rrnaetereom rawsvar.�� r <br />