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1,0/15'97 14:16 %2510 974 1232 PG&E CGT GSTS X 006 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> P(w,jo print tx lype (Form designed ler uw on ehtn 02 pitch) vvntefl <br /> NON-HAZARDOUS 1,6gnamtoe.US EPA 10 No Manlfett r Payu t <br /> WASTE MANIFEST (:AM00031757 DuaumentNo. Lof 3 <br /> 1 3 Ogngmtnen Nome ana MaIVQ Addrelt <br /> i-ACIFIL C-AZ 't EEL?C.T1o.1G Co . STTE= LIKE 9147 <br /> ?.6. rr 77o PA"TQR. N PASS ?D. <br /> 'a-U! . 'k 9.3376 :'LACY. C.A. <br /> 4.Gw»ra:�rs rhone t ., f 9 952-31,145 <br /> S.T,arW4)Orter 1 Company No— 6. US EPA ID Number A,State TranaporWe ID <br /> --..e• :4`.,•� ,t!.=r.�r- B.Trar»DVRer l Phmm,1���'` <br /> 7.Transporter 2 Coa'p;a.y Nine 8. US EPA 10 Number C.State Tranaporter's ID <br /> D.T-9-1ar 2 Phone <br /> y.0061l;=46 Facility Name and Situ Addn-x; 10 US EPA ID Numrs=r E.Stato Foollhy'o 10 <br /> I 9'3:3 't.'d:•li , STLR ROA0 F.F«.I <br /> ,L4T_<rH(-A4 Clk 95336 CAD490794131 °'''p'°"° <br /> . `2?t?j 992—b 2'3x3 <br /> 11,WASTE DESCRIPTION 12. Contel mm 13. 14 <br /> Total Unit <br /> No. Type Qmmlty WLNof. <br /> I a <br /> N� 9�AZ1tR4013S 401T, 41 DT / <br /> G b. <br /> E <br /> N <br /> E <br /> fl �. <br /> A <br /> T <br /> O <br /> R d. <br /> n <br /> I G Addit,eaal Deacnptlone for Matorlals Llste l Above H.Mantling Codae for Wastes USwd Above <br /> n <br /> Z I I <br /> 1, GpeGal Hnndlmg I—m,Gbana a,d Additional Informedpn <br /> = I I <br /> 7 <br /> Z <br /> tr.GENERATOR'S GERTIPICATION:t t,eteuyy eerUfy that the cantmm of III*ahfarnant me fully sad em"Iffaty desat med and w ift a roww e <br /> :n proper COWIM:r.ix t*n—j.ail.Thu matai LUe debcr'bed on this man,feat are not in lndaral hliardaus waste nWiNUWS <br /> Date <br /> Prinlod/Typed Name $fgnaturo MonrJ: oay Year <br /> t i <br /> T 17 Trehaocm <br /> orter 1 Acknowladgenl 01 Necepl of Mat0315 Date <br /> R nuturo NamB Month Day Yoor <br /> />, Prntpd(Typld ..rte / <br /> IC) T.ansparter2 AcknoMtCgermant of Rocelot of Matcr'ala Data <br /> TPdnradrTypod Name Signature Monm pay year <br /> E <br /> R <br /> 1 Q.DUcropaacy Indication Spaca <br /> F <br /> A <br /> C <br /> I :'' Fac'I.ty(--r or OpenstorC;grTceCon er e0c(hot or the wzxfe maten8lS Covered oy rn,menifea;,except ea natod in.Im..1 D. <br /> L Date <br /> T PrintedRyped Nome 7== <br /> Mon:lr f181' Ypar <br /> Y <br /> : 1 1 <br /> Fla f•rinted by Lubulnmblur,An Amaacam Labelmurk Uri-ChicuyC,IL et) 5 (900)621.5708 <br /> :��'/i <br /> Asi,�rwnriD ON NEoTu>;D se.A ?.,i.ns.m, Rev.3195 <br /> YiIN6:btBt►n i.a _ •1S4Y INK,. <br />