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a of Cal fornia--Enviranmental Protection Agency <br /> s Approved OMB No 2050-0039(Expires 9 30 99) See Instructions on back of page 6 Department of Toxic Substances Control <br /> se print or type Form de=igned kr use on elite f f 2 pitch)typewriter Sacramento California <br /> UNIFORM HAZARDOUS 1 Generolor s US EPA iD No Manifest Document No 2 Page 1 Information in the shaded areas <br /> is not required by Federal low <br /> WASTE MANIFEST L ' `u � � a 15 of <br /> 3 Generator s Narna and Mading Address A State Mantfest Document Numiser 98166885 A <br /> f1 Shire Generotoe,ID <br /> 4 - <br /> 5 <br /> rfcrisporfer I Company Nome 6 US EPA ID Number C Stole Transporters 10 <br /> A+SBURY ENV I PONM£NTAL SERV ICESD Transporter s Acine <br /> C I31@i886- 400 <br /> 7 transporter 2 Company Nome B US EPA 0 Number 1E State Transporters 10 <br /> F Transporter s Phone <br /> 9 Designated facility Name and Sue Address 10 US EPA ID Number G Stale Facility s ID <br /> RAMOS ENVIRONMENTAL <br /> 151; Sim WSP M.40 NCK" A ME91 H Facility's Phone <br /> I C 1911 }37 1—5747 <br /> 12 Containers 13 Total 14 Unit <br /> a 1 1 US DOT Description(including Proper Shipping Nome Hazard Class and 1D Numbed No 7 pa Quantity Wt/Vo) 1 Waste Number <br /> a NDN-RCRA HAZARDOUS WASTt, LIOUID slate <br /> >' f WATER,O.L) EPA/Oilier <br /> ' E No P?acar Rec"ired <br /> a N b stale <br /> E <br /> REPA/Otfrar <br /> v A <br /> = State <br /> aha O <br /> R EPA/01her <br /> soud State <br /> I.- <br /> Z <br /> w <br /> V EPA/Other <br /> w <br /> Z <br /> J Additional Descriptions for Materials Listed Above K Handling Codes for Wastes Luted Above <br /> 0. <br /> Karim <br /> w <br /> Qu —j". c d <br /> Q ERG <br /> 15 Special Handling Inslructsons and Addit(on)Information <br /> r <br /> Z 3LCflE9 i 60f�L$$ � SLN`�$idE'1 C 1N Ll i s?4Pcr�a <br /> ta�o)�a7-�aua <br /> ud <br /> I6 GENERATOR S CERTIFICATION l hereby declare that the contents of this consigamens ore fully and accurately described above by proper shipping name and are classified packed <br /> Q marl ad and labeled and are in all respects in proper condition for transport by highway according to applicable international and notionof governmant regulations <br /> V <br /> J <br /> if I am o large quantity generator I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree t have determined to be economically <br /> a practicable and that I have selected the racticable method of traatmen+ storoge or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment OR if I oro a sma I quanhry generator I have made a good froth effort to minimize my waste generation and selecs the lies+waste management method that is <br /> Oavailable to me and that I can afford <br />} Printed/Typed Nome Stgnarura _ Month Day Year <br /> Z r ✓ h__ <br /> W N 17 Tras <br /> ns orter 1 Acknowled ement of Recei t of Material <br /> ti R Printed/Typed Name �,jP-y1 �r 1'.s y Signature / , Month Day Year <br /> IL- 0 1& vans oAer Ac nowled ement of ecei t of Materiols <br /> 0 p Printed/Typed Name Signature Month Day Year <br /> T <br /> w E <br /> V7 p <br /> a <br /> 1..J 19 Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> f <br /> I 20 Faci1H Ownar or Operator Cartihcolron of iecei t ul huzu,Juu need, jol i nvi riid by this manifest except as noted in Uem 19 <br /> Printed/Typed Nome Signature Month Day Yen <br /> DO NOT WRITE BELOW THIS LINE <br /> Yellow CENERATOR RVAIN <br />