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,12/08/2003 09: 19 916-386—ag16 _ SACTO 0—C 760 PAGE 04
<br /> Form Approved OMB No.2050-DO39(Efpires 9-30.991 " See Instructions on back�ge 6. Do rtmonr of Toxic Subsreneee Contn
<br /> Plecso print or type, Form designed Few use on tiffs f 12-pftehi 'Pilot.. Sacramento,Colifornio
<br /> A. UNIFO HAZARDOUS 1 Genarators US EPA ID No. Monifnst Document No. 2, Pogo I Information in tho,hodnd areae
<br /> STE MANIFEST " 'L•n' 0.�6:3� 1 6• �' /v-.% is not required by Federal Ip-,
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<br /> 3. Gonerotpr's Noma ond•Acs;ling Address o c=.,. r . rH !%1".t ,Y'U(: t "I
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<br /> 11. US DOT Description lincluding Proper Shipping Name,moZOH Clogs,and ID Number) 12. Containers 13. rotol 14, Unit
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<br /> Q16, GENEaATOQ'S CERTIFICATION: I hereby declare that she conterstt of this conslomm r oro Fully and oeeurately described obovt by proper shipping name and oro cfoseified,pocked,
<br /> V marked,and labeled,and ore in all rospods in proper eenditia,For transport by highway arcing to applicable Interno(i0-1 and nolionol govornmgnl reguloFions.
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<br /> -' If I am o for a antiy eorobr,I cerci that 1 hove o
<br /> s g Orr h ga certify rarn in place)ro reduge the volume and totsicitY of waste generoPed N the degree I have determined to be ecbnomically
<br /> y pwoetieeble and Mm t eve selected tM practicable method a tweaienew,storage,or disposal currently ovolloble to mn which ml:nirnizos the present and future threw to human hsaltfs
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<br /> and rhe environment;OR, if I am a small quantity gensrebr,I hove mode o good Faith effort to minimize my Waste generation and select the best waste monogamont method that is
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<br /> DTSC 9022A 11/99)
<br /> EPA 8700RECEIVED 12-07-' 03 19: 17 FROM- 916 386 4926 TO- CCKW-FRENCH CAMP PO4/04TAINS
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