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roc sr,r <br />STATE OF ARKANSAS <br />RECEIVED <br />R Department of Pollution CAWi and Ecology <br />P. 0. Box 8913 Little Rock, rkansas 72219-8913 — <br />°° Telephone 501-562-7444 SEP 15 <br />Please print or type. (Form designed for use on elite (12 -pitch) typewriter.) Form Approved, OMB No. 2050-0039. EXPIRES 9-30-96 <br />Generator's o. as .- • • ge Information int e s a e areas is not <br />UNIFORM HAZARDOUS Document No. required by Federal law. <br />\A/ACTC RAAK11000T I AI n fl fi I (1 1 <I 71 71(.17 Ill 1n Ir, 11 1 of 4 <br />G <br />E <br />N <br />E <br />R <br />A <br />T <br />C <br />F <br />3. Generator's Name and Mailing Address . O <br />Pacific Coast Producers <br />A. State Manifest Document Number <br />AR -76752 <br />835 S. Stockton Street <br />B. State Generator's ID <br />Leith , 1CA 9PP241 <br />4. Generator's Phone( 7 <br />5. Transporter 1 Company Name 6. US EPA ID Number <br />C. State Transporter's ID All <br />Triad Trans ort, Inc. 2 ED 90 11 <br />D. Transporter's Phone 918-426-4253 <br />7. Transporter 2 Company Name 8. US EPA ID Number <br />E. State Transporter's ID PC - - - - H - - - <br />F. Transporter'. Phone <br />9.Designated Name and Site Address 10. US EPA ID Number <br />G. State Facility's ID <br />vFacility <br />RINO <br />1007 Vulcan Rd. -Haskell <br />H. Facility's Phone <br />Benton, AR 72015 i EL19181 S <br />7101 <br />501/778-9089 <br />12. Containers <br />13. <br />Total <br />14. <br />Unit <br />11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) <br />No. <br />Type <br />Quantity <br />wt/vol <br />I <br />Waste No. <br />Wa,kP:aftRe1&dMAffii <br />001/D018 <br />3 LL'gI2 3 P(MI RQ( D018) <br />0 10 1.3Q111615G <br />F0031F005/DO35 <br />""Va4e Part R&edMatad <br />0 0 7 <br />0 0 3 8 5 <br />001/Fo03 <br />3 UNI263 P(M <br />0 1 0 1 X <br />1919 X119 <br />G <br />05/D018 <br />c\Va,le Rwirrlabbie Ulluid, N.O.S. /M& 4 Edryl '&m) <br />0 0 1 <br />0 0 0 5 5 <br />001/F003 <br />LINT 1993 PG1H <br />0 <br />1 19 <br />G <br />05/Do35 <br />q3 <br />Wye ICLigLid? .O.S. F SI I} <br />001 <br />3 UN1993 PGH <br />005 <br />00275 <br />G <br />J. Additional Descriptions for Materials Usted Above <br />K Handling Codes for Waates Usted Above <br />a. 9502-01454 ERG #26 ( Paint Filter, Paint & Solvents) CAcode: 461 <br />EMERGENCY RESPONSE INFORMATION: <br />1J. 9502-01521 ERG #26 (Waste ._Paint & Solvents) CACode:461 <br />Jamie Garcia <br />c. 950403760 ERG #27 (Sealant Resin Sludge # 2)CAcode:281 <br />""_12x48—E-R �n 85}�*cudc-1N---_�----- <br />209-334-4411 <br />if no alternate TSDF, return to ge r t n pate,• 8/18/95 11:00 a.m Lgad <br />8822 <br />15. Special Handling Instructions and Additional Information <br />16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are <br />classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national <br />government regulations and Arkansas state regulations. <br />If I am a large quantity generator, I certify that I have a program in place to reduce the volumn and toxicity of waste generated to the degree I have determined to be <br />economically practicable and that 1 have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and <br />future 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 <br />the best waste management method that is available to me and that I can afford. <br />Printed/Typed Name Signature ' Month Day Year <br />Bob Hieb 101811181915 <br />TR 17. Transporter 1 Acknowledgement of Receipt of Materials <br />A Printed/Typed Name Signature Month Day Year <br />N <br />S <br />P <br />D 18. Transporter 2 Acknowledgement of Receipt of Materials <br />R Prinqtedp/Typed Name ) Sigraa�ture% Mo�n+th) Day Year <br />R / 1 IdL I I (� t( 1� ! O / r' /t !L./ A �/ // 1111 XII i O 17 k <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />I <br />L <br />1 20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except o Item 19. <br />T <br />y Print /Typed Name Signature Month Day Year <br />EPA Form 8700 2 (Rev. 9-88) Previous edition is obsolete. <br />