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WENDT CONSTRUCTION 2095479312 04/17/04 09:SSam P. 002 <br /> Agency See Instructions On back of page 6. Department of Toxic Substances Control <br /> ,pires 9-30.991 Sacramento,California <br /> ,r use on elite(]2-pitch)typewriter. .... <br /> - Generator's US EPA ID No. Manifest Document No, T. Page 1 Information in the shaded areas <br /> HAZARDOUS <br /> is not required by Federal law. <br /> ,iE MANIFEST > l t of <br /> ale= � vc�U �v � 7 ,r <br /> ror's Nome and Mailing Address {, aOP` A. State Manifest Document Number <br /> }� 227,830- <br /> tf v,-,4 tX 4'"',e � 8. State Generator's ID . <br /> �� 133-34 c�3 9 . . : <br /> A <br /> . erator's Phone <br /> sporter 1Company Nome 6. US EPA 10 NumberC. State Transporters ID Reserved.)D. TranspartersPhonerter'sIDesporter 2 Company Nama 8. US EPA ID Number <br /> F. Transporter'sPhone <br /> �.y Q 10. US EPA ID Number G. State facility's ID <br /> Designated Facility Name and Site Address <br /> �r H. Fa 1t 's Phone <br /> © ZV N rs» Oj s 12. Cantainers' 13, Total 14. Unit <br /> DOT Description(including Proper <br /> Shipping Name/,Hazard!Class,and ID Number) No, T pe Quantity Wt/Val I Waste Number <br /> _ ., - a. (.�N ♦ fals.�P:i!)LZ Eother <br /> PAI <br /> f/ <br /> ffff <br /> �jf✓I�` �LC .I-c t ..._. _.. State <br /> E - <br /> .N b. EPA/Other <br /> 00 <br /> a0 E <br /> N R <br /> A State <br /> c. <br /> T EPA/Other <br /> 00 O <br /> R State <br /> Lu d. <br /> EPA/Other <br /> us <br /> sss ° r K. Handling Codes For Wastes Listed Above <br /> i t it 1 "Arfn�� p^�i tlafP j+tatuena{s L1sMd Above i r+ G <br /> r e <br /> r S y f KRx� 1�r{,E t Yr <br /> t •tin 7. F�,� �e �r L FrA C. d. <br /> 15. Special Handlin in ructions and Addi Iona{Information ^ F-1(,rrr+<. (0�ij7 <br /> U<j2t �l'crn�•`C� �q�Jw•1 1^� � <br /> 12 <br /> Q <br /> w <br /> 16. GENERATOR'S CERTIFICATION; I hereby declare that the contacts of this consignment are fully and accurately described above by propor shipping name and aro classified,packed, <br /> Umarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable International and national government regulations. <br /> If I am o large quantity generator,I certify that I have o pro ram in place to reduce the volume and toxicity of waste generated to the degree I have determined to bo economically <br /> practicable and have selected the practicable method o treatment,storage,or disposal currently available to mo which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a small quantity generator,1 have made a good Faith effort ro minimize my waste generation and select the best waste management method that is <br /> of available to me and that 1 can afford. <br /> O Printed/Typed Name <br /> ;✓" ._ Signature j <br /> Month Day Year <br /> us T 17. Trans orter 1 Acknowled an <br /> f Recei t of Materials - ' <br /> P..._ r / Month Day Year <br /> W p Printed/Typed a Signature / ,� /1� <br /> I r�uj 0 18. Trans rte,2 Acknowled ement o£lt cel t of Materials Month 'Day "Year <br /> Q T Printed/Typed Name Signature I -� <br /> LU E <br /> V 19. Discrepancy Indication Space <br /> IF <br /> _ A <br /> C <br /> 20. Focili Owner or operator Certification of receipt of hazardous materials covered b this manifest except as noted in Item 19. Month Day Year <br /> T .Printed/Typed Name ' ': Signature <br /> ] r <br /> i Y <br /> DO NOT WRITE BELOW, THIS LINE. <br /> EOTSC 8022A),1/99) Yellow GENERATOR RETAiF{S <br /> ! zs 8700—27 <br />