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10'15'97 14:17 '$510 97.1 3:32 PG&E CGT GSTS Cj007 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> Pleaao 7In;w lyye from de igned k> Lex:on nMo(12Pilch)tyDeWrw) <br /> NON-HAZARDOUS t Generawa Uta EPA 10 No Oonlfc7t Z.rvo. Page <br /> WASTE MANIFEST '"M-11031757 ►�IO?- G'- ! <br /> 3 Ccnnmtara Name and Mailing Addrom �„�T t <br /> x!''•.( (�S `u =?,1 Ric r[t. 1F,. LiN <br /> .,",,. 'f:'1 `:.". <br /> 1 —FACY' rA 9537b :'RACY. CA <br /> a.Gvnerata-s Phono( -V It} 95.(-3194- <br /> 5.Transports,t Company NArrr 6 US EPA 10 Numper A 3Satg TranSDonees 10 <br /> H.TrenepCVar 1 Pr" <br /> 7 Trsiwpuite(2 C4mp11ny Name 0- 1)9 CPA IO Number C StAt Teensportere IO <br /> l - D Trnncporter 2 Phone <br /> ,,3,p"ignuuuu Facilay Nara and Site Addrosa 10. US EPA It)N-wila r F Srara rwjuty'z to <br /> J499 'st�CFTid� triitii�I; r::;9► (L �] _ <br /> MANTYL� CA 95335 (..\�i1�J=.1�7(iY1J3 FFAclhty'z Phone r75 9 nJr, <br /> I! WASTEOESCRIFTION tz. Gorna oars T.W Unit <br /> No. Type oua,+hty wt./Vol <br /> � I a <br /> SOIL VI 1T Y <br /> G b. <br /> E <br /> N <br /> E <br /> R <br /> A <br /> T <br /> O <br /> R d <br /> n <br /> I G AddlDonal D95Crbrlons for Material*Uslnd Abuve N "andfulg Cedes for Wutvv Uatvd AbOvO <br /> .!i73 A<:G::rTAv(_E xn. 62 9-F32 <br /> 7 <br /> S � I <br /> V 15.SDacml NAedllna marn+crlonz and AtlUiLunal IntormaDon <br /> y i��rf <br /> 'r.GENERAT014 S COMFICATION:I htrrahqq certdy that 1i1r nnrdnntt of thea ehlpment aro fUlry anti ae..+ru1.Iy dmenDeo end are In all reSpeate <br /> m proper corl�tfon for uw+ePu�t.Tile matvrisls dexrAed on thlo mnndaf are not svblvct to rai tm>•4mr+'r< regulations <br /> Uatc <br /> ' Pn IW I ypvd Name S'gnatury Morm Uay Year <br /> a <br /> T 17 Traneoorto,1 Acknow ed9amaar 01 Reaelpt of MPt+:,L+l- -_ Data <br /> R signature Month nay vas, <br /> A Pnmedrrvoed Namc , <br /> P , Dstc ' <br /> 0 19 Transpmtor;,'AcknoWteddWMnt of Eit"11PI of mplerlals <br /> T PnnlerVTyped Name Signature hlMth Day Ym, <br /> E <br /> R <br /> 19.D-scrNDdncy IndfCallan SDacc <br /> F <br /> A <br /> C <br /> I Favhty Owner x OM'rotor:09nif;CDUDn a1 receipt Of the waste meterle,vv¢raU by 7de ma^Ifvst,--01 as natrd m 1"1 g. <br /> Date <br /> S,gnalure <br /> T PrintedlTypod Nanlr <br /> Montyr Day veer <br /> Y <br /> t'AfLtl ®ynlrfrtp oa rFcrafD v.rta^ nn wrr Rev.L25 <br /> nr` <br /> c1a Ftpd by Labtr!a 91 An Amerman LeDelman,Co.Ch'Co to,IL 60W (SM!er. oy;nn�r ISOr ;. <br />