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09-02-2004 0 7:5 5 PM I.,FROM-SAFETY ISTMEN.T +7703844142 T-457. P.004/007 F-461 <br /> Brute of ptowilan A <br /> .rnF <br /> gg 1%qA <br /> -3 -99) See Instruef ions on back of page 6. Department al'Texh:Substances Centro! <br /> NF-11 =1MMIM 49FIe(12-pile4z)lypawriter. Sacramonla,rolifornfis <br /> �UM <br /> FOHAZARDOUS 'Monilesi Document No. 2, Paso 1 into.allmillijbil a —05 RM i <br /> WASTE MANIFEST 5±T11?19111121P 1 141 , -7 d2 is nor ry wimvd deral low. <br /> 3. 156noralorA Name and 01011149 Address DEPOT <br /> 1905AMn1ltvenue#9an 'Wffl_ <br /> Carlsbad,CA 92068 80 OO-8220 <br /> A. Gonarawea Pitons I <br /> M <br /> V Transporter I Cori"Orry Name 6. U5 WA ID Number rl <br /> in ......... <br /> COP <br /> SLATE INDUSTRIAL SERVICES,INC TT001001'lf <br /> 7. Transporter 2 Company Name G. US EPA[D Num.bar <br /> y <br /> lhd IlSlfl�) SK,Of IT- <br /> io UM <br /> 9. Designated pact fry Name and Silo Address 10. US EPA ID Number <br /> POLLUTION CONTROL INDUSTRIES <br /> Ib <br /> , <br /> 4343 Kennedy T <br /> y Avenw <br /> 1100 <br /> East Ch[20a, IN 463121 L I1-11""'_'1!!: <br /> INP9[P0 <br /> 12. C�a oulan 13.Total 7A. unit <br /> 11. LIS DOT 1105criplIp'o(including Proper Shipping Nome,Haza�d Class,and IP Number) <br /> z Type, Quantity WI/Val J <br /> � <br /> . <br /> i jE I X {RQ=1000),WaStD Flal`InMable UqUds. n.p.st.. HC3.LIN11933 <br /> PGI 1. (Paint/Solvents) '(EiRGO 126) DfO <br /> —Lfz D <br /> CD N ALa2je_Toxic LjM!ji& 0manto. mo.s..HCO.I. UN2810, PGII <br /> op E <br /> (01minan I Malathion) (ERQPffi IC3) <br /> A <br /> C) T <br /> 0 X Waste Taxle,Solids, <br /> (DlaZrian I Malathlon) (ERG#154) <br /> d. Nan- CRA. Non HazardotPI5 MaL-Priaf Stale I MR <br /> asL <br /> (b_leraD G O1hJTS2091 <br /> VIP <br /> z J.Additional E)ioscriptlans for Mcilerhift,Listed Above KHandling Codas For West.Listed Above <br /> 2 1 0. b. <br /> Ila) EI-3 110) EI-11 Sal <br /> 11h) 13-11 19 ) EI-I <br /> IS.Special Hinindliall Iftalrudians and Add1lia"na-1-information <br /> HOME DE #HDiWG 290 Commerce Avenue IN CASE OF EMERGENCY.CQPJTArwT ar-AT SWASI.$U6 <br /> w Proposal#24401 Manteca CA 95M State contact a� t39 <br /> 16,GENERAIrms C"TP1`0CA1jG1* nlam fully and occurateir described Acivir by proper shipping name and arc c[a 1Wpacked, <br /> mg(6st,Ar4labol.d,and ons in oil Fv3pv;b In proper conailian for inonvitort%7111119hway according I*cipo 1colitir Irnarnolianal and natichal qwvraffidal <br /> ram in place to nsduap the volume and laxidrycifvnisle ganoraQ'In the degree I have idalormined lobe iscarmaricoll <br /> Prarlicablo and Ifial I eye solocieJ the proclarabla method a Iroisimairl,a ly available to me which minimizes the Present and future threat to hurrism hoaIlK <br /> and rho <br /> .quantity itanaral—,I Ircryo made = <br /> his,owilroameal,OR,If I am a small TtdaUl 16 so minintiza fay%vasis Denordion and 541601 the 60BI wells mangeawkwit sallied that is <br /> 0 avalksible to me and that I earn afford. <br /> Prinloanypoid Iti 9 gnalum Month Day year <br /> 7 <br /> I"powicigornapi of Receipt of mislatialt I <br /> o1rinforl N P _r ISlenaluro month Dep Y <br /> r <br /> 0 <br /> a ow <br /> fed*list 2 fedommuril of'Radinst)of Materials <br /> ,0' 7 <br /> I Month My Year <br /> 19, %wepariGy Indi--u—Sp-re <br /> Z A <br /> C <br /> I 2a t81x 0%wriar or o e Ior Cmrd vealt n et tae I B o axordovs materials oweri;d b this sen le t arseit as otnd do Ilam)y— <br /> T MonlhDay Year <br /> Y !j i <br /> C co C.0-1, 6 4', <br /> DO NOT WRITE BELOW THIS LINE. t <br /> DISC PU=A 11199) While; TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS_ <br /> EPA 5700-22 To; .-P.O.-fl ain 3000.Sacramento, CA 75812... <br /> ............... .... <br />