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wrote or l.alitornio—Environmentol Protection Agency —- <br /> Form Approved OMB No.2050-0039(Expires 9-30-99) <br /> -Plebs riot or type. Form desi ned for use on elite(12-pitch) - See Instructions on back of page 6. <br /> g ( p )typewriter. Department of Toxic Substances Contr <br /> UNIFORM HAZARDOUS I Generator's US EPA ID No. _ -- Sacramento,California <br /> Manifest Document No. 2. Page 1 Int ,motion in the shaded areas <br /> WASTE MANIFESTQ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> shipping name and are classified,packed, <br /> tJ marked,and labeled,and are in'all.respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> J <br /> If I am a large quantity generator,I certify that I have a pr ram in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> 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 /> and the eto me and that <br /> I if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> available to ro and that I can afford. <br /> Prin�(bre?d <br /> V G J Sig atur <br /> Month, Day. Year <br /> (� R 17.-Trans orter 1 Acknowled epient of Receipt of Materials 31 <br /> l 1 <br /> NPr,ted yped Name <br /> /� �O/��/� �� Sign�Gre f % <br /> 2 P � �// i�i` / t �f� �/��-/ / / i Mont D Yea <br /> � R 18. Trans iter 2 Acknowledgement of Recei f of Materials <br /> j Printed/Typed Name <br /> i <br /> E Signature - <br /> J' R Month Day Year <br /> 19. Discrepancy Indication Space i <br /> F <br /> A I <br /> C r <br /> I I'� <br /> Li <br /> 1 20. Fa,iliIIIOwner or O'era r Cerii{icalion of receipt of hazardous materials covered b this manifest exce t as nofe0 m Item 19. <br /> T Printed/Typed Name i ! <br /> y Signature <br /> �--- ;r/�1 `Mont i ay I <br /> ' P Yeo, J <br /> DO NOT WRITE BELOW THIS LINE. Cf <br /> .SSC 8022A(1/99) <br /> Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. <br /> 'k 8700-22 (Generators who submit hazardous waste for transport out-of-state, <br /> produce completed copy of this copy and send to DTSC within 30 <br />