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State of CaWorrsla—Hearth and Werare 4)b,� - Department of Hearth services <br /> See Instructions on bock$', i ge 6. . Toxic Substances Control Program <br /> lalso>,e ptkt or type. Form desWied for wean of f T2p# pewrj <br /> . ...,j !)�j Sacrarrmerlo,CaRonrda <br /> UNIFORM HAZARDOUS .1.Generator's US EPA ID No. Manifest Document No. 2 Page 1 Information in the shaded creat <br /> WASTE MANIFEST i 71,61 jjg2jj2gj Cj(&I 146 1 1 / l I 15 , ( of is not required by Petard law. <br /> 3.Generators Name and Mailing Address A SI57Aa mRol1 m6n}- rtr6 <br /> PACIFIC BELL, <br /> 2600 Cantina ROMOn, moor 2050, Sane Rars::cn.:CA 945L3 ryet <br /> 4 Generators Phone l <br /> 5.Transporter 1 Company Name 6.US EPA ID Numberwo <br /> C Sate Ttar>spatter!I(? <br /> T C 4�� ��A Ti v N _ D l D ;;0 1rr�pFotters Pfraa•as . ..::t:� :..:: .�.: <br /> 7.Transporter2 Company Name 8 US EPA ID Number, <br /> Trofnsportai s fD :..,:... .,:: <br /> I I 1 I ! _I I I I I I 'C,Ircr 4 Plxana ' <br /> 9. noted Facility Name and SRe Address 10.LIS EPA ID Number,",-' wire A <br /> CN 13 <br /> Co <br /> PjIG/nr5(a (f* t 4 fArVfdl I.71/ Ib II I3BIyfPflclrleF <br /> ...... .............................:...-- <br /> l2 Containers 13 Total ld Urmfl - <br /> "Y 11.US DOT DescrlPtl-(Including Proper Snipping None,Fkmari Class.and ID Number) NoQuarrw 1NtN01 L 0C1tFe <br /> CL /��GN /� /J IOe+�+S -wr�sTer` `rbt•�fY. >Y } <br /> Z N b. <br /> W.0 R • n <br /> T*-QA F <br /> zT c Stats <br /> = O �. � <br /> ;Y <br /> I 1 I t I f ( 1 <br /> 1 1 I I I I I f <br /> �",�+ K.ttandk;gcedes ioE wcates - ecE A�o,ie <br /> tip`,_ �it►J�,i' r Y1r a b <br /> LU <br /> GX IXrM. <br /> Lu „ ........... t ........ ..... ... <br /> U 15 Special Handling Irvtructkuss and Additional Information EMERGENCY RESPONSE CONTACT. (415) 823-7177 <br /> 0 �+I.0 w,,uS � X'C:c_� m.r -t <br /> 2 For Instructions cn flow to comply'.® manifest call Per. Bell Env. Moist on (415) C23-9,24 <br /> q 16. GENERATOR'S COMFtcATioN. I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> Opacked.marked.and labeled,and ore in all respects ion proper corndition for transport by highway according to applicable International and national government regulations <br /> Qif I am a targe quantity genwdor.I certify that I have a program is place to reduce the volume and toAcRy of waste generated to the degree i have determined to be <br /> Z economicaly practk;able and that I have selected the practicable method of treatment,storage,or disposal currentlyavdiable to me which minimizes the present afuture <br /> w threat to human health and the envkonment:OR.r r am a small quantity generator,I have made a good forth effort to mU*nW my waste generation and select the test waste <br /> rrmabogement method that Is avoksble to me and that I can afford. <br /> J <br /> Q <br /> Printed/Typed Name Signature MonthDay year <br /> v) T 17.Trac sporter 1 Acknowledgement of Receipt of Materials <br /> pR Printed/Typed Name signature Month Day year <br /> U A <br /> N / <br /> O 18.T.potr 2 Akn..4.dgnt of RecW of Materkals <br /> Lu <br /> R Printed/Typed Name Slgndure .< Month Day yea <br /> w T <br /> E <br /> Lu <br /> Q F 19.DiscroparxY fndic[Rion space <br /> C ,5 <br /> , 20.Facility Owner or Opefdor Certifrcalion of receipt of hazardous materlak covered:by this manifest except as noted in Rem 19, <br /> T PrintedAyped Norrie Signahxe Month Day:: year <br /> Y <br /> k <br /> DO NOT WRITE BELOW THIS LINE. <br /> DHS 602?A(12l90) Um: GENERATOR SENDS THIS COPY TO DNS WITHIN 30 PAYS w <br /> EPA 6700-22 To: P.O.Box 400.Sacromento,SCA 9581243400°' <br />