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UNIFORM HAZARDOUS GeneratorsUS EPA ID Nd Manifest Document No. 2. Page 1 Information in fie haded areas. <br /> WASTE MANIFEST is �t,e �by de,91 low. <br /> 3. Generator i Name and Mailing Address - - Fe Maru(est Doc""imerd� <br /> j _ <br /> J QUAIBX. •APC <br /> n 555 lnsiu.^rrial part Drive iCJF3klt::- <br /> r Haritern, CA 95317 <br /> Generator's Phone - <br /> m <br /> t+s S. Transporter 1 Company Name - 6. US EPA ID Number +s`-' <br /> aF° ZOt <br /> m FX9 Ref inirxi 795 RA>,t Stt oat- <br /> J -Santa Clara. Cs k h V, 11. r r1 1; r- ') - <br /> r 7. Transporter 2 Company Name - 8. US EPA ID Number - • --S7rma rte%i 1D c+'il�." .'-s#'s ,,6a <br /> V Tti-State 14ator Tranait CV - -g� <br /> P O. 'Crux 113. diol u,. ric a 181 it If ; '1 .1 a, -, '1 4 s .1 a `.tRR "#mac M <br /> 4 Q PVV <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number G State Faml si1D:c:+t. <br /> Jz Hallmark RallruDo Coup. <br /> . T �Y`�� <br /> 70 1?,3 ''ad� 'dxla Rd <br /> �w A Q 9 s�o g 7690 (e H fd<ii8 s ane £Y <br /> JV 1 r Vn n i •ylq to <br /> y _ <br /> Z i 1. U8 DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) - 12 Containers 13 Tata] 14. Unit <br /> No T Ouomity WI/Vol LyWaste m6er <br /> f� a' <br /> ;3 F.ti. Ftazar+l,va k{a •t, it rid, n.o .. CI.Ase nn � <br /> o E H 3U7?, CGI1I t er ; V !J r ' EPA)04.F. <br /> 0 <br /> 1RP&arA <br /> sa E RQ, Hazardous. Ha to Solid. It v s CL:ass > NO MR <br /> v R9, 1443077, P'3111 (Sinter ) 0 ' 3 D �IQ C EPA9�aeher}, v <br /> O T C. Sta4" <br /> zR -A�oxer -- <br /> Z d Stole.. se <br /> Wic <br /> V <br /> W IiPA�Other�.. ueb:-. <br /> N w <br /> Z - -4 ddmagel phorysfar :. egek ..:•.-'k asst-x- a(, Ic$il to esu Iftei w, *. <br /> a iJ. ETE <br /> to 3 u +� <br /> w+ <br /> J 19t •`.�s. '�aTo' ^�, 93 r bs eL �<f' d#Y1>:-r-a:'s <br /> 15.cs r s"'_:n;',�' .2;# �:7+..' e„Ys..'-' 'n. - .a7€'+`:�',+ r`r.. .%Y•a .e'.r:�', m.- i s` . <br /> Q `15. Special Handling Instructions and Additional Information <br /> Znl7ear G1ove r o+iq Las a T EPG 71'' <br /> w <br /> "4 11,ur <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contorts of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> packed,marked,and labeled,and are in all res ects in proper condition for transport b highway according to applicable international and national government regulations. <br /> Q P P a P Y 9 % n9 PP 9 9 <br /> V <br /> If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br /> economically 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 /> Nthreat to human health and the environment; OR, 4 1 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 /> Printed T ed Name , <br /> Q / YP 9grvNre i Month D% i /Year <br /> V T 17. Trans der 1 Acknowledgement of Receipt of Materials <br /> (7 N Prinyd�TYPed Name Signature _ _ , I -+^ ""a D% Year <br /> 0 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> W i Print �yNd 1 11Y Si �o AD Year <br /> W 9 <br /> O e <br /> E p, <br /> W K. Discrepancy Indication Space <br /> N <br /> Q F <br /> V A <br /> C <br /> Z I <br /> L <br /> I rkPr!0�1�t�ypp!d7N <br /> Fr or O erator Certification of recei t of hazardous materials covered b this manifest exc< 1 as noted in Item 19. <br /> T meSignature : Month D% YearY ,7 , GRee„ wt;l /u % t: �� t> / D �i 9 <br /> } DO NOT WRITE B OW THIS LINE. 5625 <br /> DISC 8022A (9/93) • Green: TRANSPORTER RETAINS, <br /> EPA 8700-22 <br />