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a a': AID <br />S:ial ornia—Environmegal Protection Agency ��gs�+�t� �g F �° r <br />" 16 0,$ <br />rm App��rovedOMB No. 2850-0039 (Expires 9-30-94).. S@@ 111s$rUc$IOflB 011 back ag@"6. Department of Toxic Substances Control <br />.P edse;'p'rirTt- e... Form designed for use on elite (12pi►ch) typewriter. - Sacramento, California <br />UNIFORM HAZARDOUS <br />1. Generators US EPA ID No. Manifest Document No. <br />2. Page 1 <br />Information in the shaded areas <br />Federal <br />. <br />WASTE` MANIFEST : <br />�! 03 �% 75 9 .. <br />; <br />snot re uved b law. <br />q ' y <br />of <br />3. Generator's Names and Mailing Address PACIFIC COAST PRODUCERS" <br />® <br />835 S .StOCKTO . ST <br />in <br />FSO BOx .550 <br />LODI Cry 93240 <br />in,, <br />4. Generator's Phone 2051 334-303 <br />00 <br />5: Transporter I Company Name 6. US EPA ID Number <br />°° <br />Sly ETY xL kgk C0RP .,9 49, SnO2 <br />Q7. <br />Transporter 2 Company Name 8. US EPA ID Number <br />(J <br />Q <br />9 Desin{yet;eg+d Facili Ny}Yawme4and�Sti ddress „ .: 10. US E1P flMtmr��� N m er _ <br />�i �iY. <br />® <br />_ , <br />O O. t�2IgAI i LVD <br />oo <br />SALIDA >..' CA. 93365 C <br />V <br />iQ <br />Z <br />12. Containers 13 Total . 14. <br />11 U3 DOT Description (including Proper Shipping Name, Hazard Class,. and ID Number) ) ; <br />No. Type ant Wt/Vol, <br />S <br />t,$ <br />a.' . ., ; ,:, ,,. �« d: 1 <br />'1k L;:ti.IM77AatAP 3'i #f� NA 199 :PGI � (l�db' ' N E <br />( ERG#2 7) 6.7 LBS/ AL <br />do N b. <br />00'.E Rte WASTE COMPOUNDS;CL AN'INO LIQUID 411 <br />N Y R (r IONOETN,AtNOLAM I NF_)`8,_0A11 740 PGIII DM ` <br />A (D005) ( RG 60 ) <br />PIP <br />Q <br />Z. d <br />„ . <br />LU <br />„ <br />r CJ <br />O <br />CL , <br />W <br />Q <br />O15. Special Handling Instructions and Additional Information <br />,=EMERGENCY RESP#708 -OSS- 4660 24HR <br />Z <br />W ,. aK00T 3 ,: S°rJ 566 C': <br />16. GENERATOR'S CERTIFICATION: 1 hereby declare that the contents of the consignmentare fully and accurately described above by proper shipping name and are classified, <br />acked, marked, and labeled, and are in all res m proper condition for transport b highway according to applicable federal, state and international laws. <br />-< P P P Pe P Y 9 aN 9 PP <br />If I am a large quantity generator, I. certify that 1 have a program.in place to reduce the volume and toxicity of waste generated to the degree 1 have determined to be <br />aeconomically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which -minimizes the present and future <br />N ' threat to human health and the 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 <br />waste management method that is available to me and that I can afford. <br />' Pn ted/Ty d Name Day ry r <br />u ( ell / <br />Z :T 17. Transporter 1 Acknowledgement of Receipt of Materials <br />UJ a <br />O AA Printed T ame Si nature � , Month `Qay y r <br />/-^++y� /^� 9/ �p <br />W S <br />4✓ ` U <br />rL , <br />P <br />1 0 18. Transporter 2 Acknowledgement of Receipt of Materials <br />W i Printed/Typed Name" <br />Signature Month Day ; Year <br />LL E <br />®- <br />ua k' 19. Discrepancy Indication Space <br />A <br />Z'.0 <br />I <br />I: 20. —Facility Owner or Operator Certification of receipt of hazardous materials covered b this manifest except as noted in Item 19. <br />T Printed/Typed Name Signature Month Day Year <br />Y >;` <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (7/92) <br />EPA 8700-22 Yellow: GENERATOR RETAINS <br />