|
Stoleof California--Emironmenfal Protection AT.
<br /> Para+Approved OMs No.2Q50-0039(Expires}- 99) See instruaions on back of page 6. Department of Toxic Substances Control
<br /> typ
<br /> Please print or e, form designed for use on aW(12•pilaN►YPawritsr Sacramento,California
<br /> UNIFORM HAZARD®US 1•C4aneraror's US EPA ID No. Manifest Document No. 2. Page 1 informat#on in the shaded areas
<br /> WASTE MANIFEST O $?2 -L 1 is not required by Federal law.
<br /> a aft
<br /> Name and Mailing AddrosaHOME DEPOT s::•
<br /> 3. Generators Nam 11:='SHsle'Moil`sfesFD¢ciepAFlutifDeY':.:? :,r<
<br /> 1006 AsRln Avenue 0 -
<br /> S''';$tgte?Ge#t -,
<br /> CadSbad.CA 82408 800460-3220 $., _
<br /> srl A. Generators Phone
<br /> t\ -
<br /> tV 5. Transporter ame 6. US EPA ID Number :��:{,S ;' =•i- :•,.
<br /> .rn Transorter i Company N ,���rra��sn�rloq•a�i:rv0a:: =:�:� :�<�ppm �f'��•
<br /> OD
<br /> SLATE I bx` %v+,tily�,j(�z`y,C�'•::td�`�.-:•ti`':}��>t.vY .•yji:^2 .. 4
<br /> NDUSTRIAL SERVICES,INC. TXROOOD61466
<br /> 7. Transporter 2 Company Nome 8. US AIL? :::.. ,t, :F x,}c.•' ::,:;.c.;
<br /> s - EP Number jE;S(6te Xi tin'siitar al 'Rdieived:J, =:.'z"
<br /> -
<br /> �`•'71///�j
<br /> Q V Ve+�Q V, r ��r ��1� � •T�:��.{�9�3flB.�x�'.`'.'�:;;n;Srfi`..'`.9;�,�=�.'�t,�^,i:i:i:r.�;•;K...;;;•:,
<br /> V oca I d i
<br /> D
<br /> 9. Designated F :' «,>^ :'.a.: .:. tx A c •.•r.:v+.,e<,..,..
<br /> yy�� ty Name an d Sita Address iQ. US EPA ro Number 'Gi:'�5#a}�;FtietJ(tycs,lp;•� ::x•; •:r• =� ;;,xrr,t,�T.�4 :(
<br /> POLLUTION CONTROL INDUSTRIES :l
<br /> a 4343 Kennedyvenue
<br /> AF'c�t.•#,Pfionei':.";. i.- 'i•:% '<i=:�%"'' ,-.
<br /> f00
<br /> il..
<br /> East C ';{' - _,; :• -�9.c+ iii: i
<br /> tldca a, !N 46392
<br /> 3
<br /> V
<br /> 12. Container 13:Total ±:14. Unit
<br /> % 11. US DOT Description(including Proper Shipping Name,Horrid Clots,and ID Numbed "- c�.;+•. ?; ?;:
<br /> Z v. No. T Quonfiy Wt/Yol ,( Yi?gsta:JVifiiili¢F:= f;_
<br /> X (R0=100#),Waste Flammable Liquids, n.o.s., HC3 UN1933 ;S4 .Llt�t('0 '!$( '=
<br /> G PGI 1, (Paint/Solvents) (ERG#9282DMG Epa/gihar {
<br /> :;o(tte2i4FfM.
<br /> E X Waste Toxic Ll olds O anic.n.o.s.,HC6.1, UN2810, PGII :::..; pig•: }
<br /> �r R ([Xazinon 1 Malathon) (ER(3#153)
<br /> A
<br /> $ T X Waste Toxic, Solids,Organic,n.o.s., HCI3.9 D.016
<br /> ® PA/Ot "
<br /> R (Dli3zlnon f Malathion) (ERG#154) TS402H
<br /> d' Stale
<br /> Non-RCRA, tion Hazardous Material Nle t NH
<br /> w (Latex al D o"OLITS2091
<br /> J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above
<br /> a. b.
<br /> 99a) El-3 19c) EI-11Sal
<br /> 11b) EI-11 lid) EI-1 � � C. d.
<br /> a _
<br /> QI5. Special Handling Instructions and Additional Information
<br /> HOME DEPOT#1-10711M 2M Commerce Avenue IN CASE OF EMERGENCY,CONTACT 3E AT 800 AS1.8346
<br /> Proposal 0 24401 Manteca CA 95M Store Contact# 209MI399
<br /> W e
<br /> 16. GENERATOR'S CERTIFICATION: 1 hereby declare that the contents of this consignment are fully and accurately described above by proper sh, iag name and are classified,packed, l
<br /> m9rkeci,aod,lobeled,and aro in all respects in proper condition for transport by highway occording to applicable in�natiolal odd noliona government raguialfons.
<br /> i
<br /> If I am a largo quant itr generator,I certify that 1 have o pr
<br /> yam in plata to reduce the volume and toxicity of waste generated to the degree I have determined to be economtealyy S
<br /> w Irrauieable and thot I we selected Aa practicable method yam
<br /> storage,or disposal currently available to me which minimizes the present and future threat to99 human health
<br /> and to environment;OR,if I am a small.quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is
<br /> O available to me and that I can afford ;
<br /> Prinled/Typ�N� S'gnotureMonth Day Year i
<br /> •
<br /> 17
<br /> spa er I Acknowledgement of Recei of Materials J1101
<br /> ri /T N Signature . Month E)oy Y
<br /> S / r
<br /> OWO
<br /> u 0 8. Trans orier 2 ck owned mom of Wow of Materials }
<br /> LLU Printed/Typed me igrrotur Month Day Year
<br /> N s
<br /> VIF 29. Discrepancy Indication Space
<br /> Z A
<br /> C
<br /> I
<br /> L
<br /> I 20. Faeif Owner or Op erotor Certification of races t of haxordous material covered 6iris manifest exca t as noted in item 19. j
<br /> T �ed/Typed Name Sig Monts Day Year i
<br /> Lf
<br /> LA
<br /> DO NOT WRITE BELOW THIS LINE. i
<br /> t
<br /> DISC 8022A(1/94(
<br /> White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. i
<br /> EPA 8700-22 To: ._P.O.'8c;k 3000, Sacramento, CA 95812•
<br />
|