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Slate of C lifornia--Emriranmental Protection Agency � <br /> fame pd t�slB No.2050-0039(Estpires 0-30,99) 5"Instructions on back <br /> 1`10054f print Rude' form designed for use on 4R,f 12•pel writer. Department of Toxic Substances Conh <br /> Sacramento,California <br /> ? NIFOR HAZARDOUS 1' Generator's US EPA ID No. Manifest Document 2.• Information in the shaded areas <br /> cE.l1AANIFEST ,.; fs not required by Faderol low. <br /> c_ Al <br /> 684 <br /> C <br /> 3. Generator's Name and Mailing Address <br /> LMTA PLATING,. INC. <br /> 0 818 S. S9TANI5I.AUS 3M .T "k a <br /> A. Generator's Phone Qj�OrOC MN CA 95206 (209)948-2766 209)948_2,768 <br /> i <br /> sCV 5. Transporter 1 Company Name 6. US EPA ID Number S, } <br /> 21St CINIMy EHI <br /> C �1A000052803 <br /> 7. Transporter 2 Company Name �x Yci+lsce"' <br /> 8: US EPA ID Number a -•-•�}t,, <br /> t <br /> U <br /> 9. Designated Facility Name and Site Address <br /> 10. US EPA ID Number <br /> C1JZllsFII <br /> t century L <br /> M <br /> 2095 New 1 ands L)r. East s, r <br /> Cr U 4013 <br /> - <br /> CV a 131 a <br /> . <br /> U 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Containers ' <br /> 13. Total 14 Unit ,�4;, <br /> Z o. No. T !Quanti Wt/Vol 141. . `umber,, <br /> RQ WASTE CORROSIVE LIQUIDS, N.O.S. (COPPER SULFATE, SULFURIC ACID} <br /> 3 G 8 UNI16Y PGI( RQ(D112) ERG(154j <br /> o fb OD i T oP 2 <br /> (3 ` <br /> Mi K1 <br /> 00 E RQ HAZARDOUS NASTK, SOLID, N.O.S. 0116) 9 NA3177 PGIII RQ(F116) <br /> o T � B A P ¢, <br /> l-009 <br /> R <br /> iN ,ro <br /> Z J. Adddional Descriptions for Materials listed Above <br /> O a) 335792-11 <br /> W FitTRICAg8 <br /> _ 9 <br /> O 15. Special Handling Instructions and Additional Information <br /> QCALL (811) 567-7455 ... <br /> Z (IEA3 FFUPBR PROTECfIV3 CLUTfiIHG. ENE➢GENCI RESPONSE PHONE (881) 567-7455. <br /> Q16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accuratelyy desccfbed abov�R���b�yy ro r sh' to n m and,are classified,packed <br /> U marked,and labeled,and are in all respects in proper condition for transport by highway according tgoppl1 66 intematioewkood gatlona government regulahonl. . <br /> ' 0 9.gen <br /> .1 <br /> J i .. <br /> IF I am a large quantity generator,I certify thut I have a pr ram in plots to reduce the volume and toxicity of waste generated to the degree I have determined to be economically, <br /> �i practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> ce and the environment;OR,if 1 am a small quantity generator,I have made a good faith effort to minimize m waste eneration-and select <br /> O available to me and that I can afford. Y 9 t�+e best waste management method that is <br /> Z Mon h Da Year <br /> t Y !t <br /> tW T 17. Trans orter 1 Acknowled em®ret of Recoi t of Materials /�O t]() V <br /> R <br /> y,t A Printed/ ped No a ,�/ - r <br /> g S .2(� �J Signet e d <br /> w P r' Month Day_; Year; <br /> W0 18. Trans orter 2 Acknowled ement of Recei t of Materials D G ® ` .. cz <br /> O T Pri //yped Nam D <br /> Q R7 e?r 7t ,//1OT��yy (�tJ �% Signof <br /> Q [�4� Month Day Year <br /> U F19. Discrepancy Indication Space <br /> Z A C.. ' V <br /> .. Qs <br /> ( 20. Facili Owner or O orator Cert'fication of recei of hazardous materials covere this manifssf ex t 01 not Its .19. <br /> T Printed Typed Name <br /> y <br /> Month' Year <br /> pay <br /> DO NOT WRITE 0.40VI(.,T11 .:_La...-,., <br /> DTSC 8022A <br /> Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. <br /> EPA 87700-22(1/99( (Generators who submit hazardous waste for transport our-of-state; <br /> — produce completed copy of this copy and send to DTSC within <br /> TI IAI 1Iq Did 9'9A <br />