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t <br />s <br />t <br />c <br />c <br />t <br />t. <br />4 <br />c <br />u <br />1: <br />c <br />s <br />L <br />L <br />U <br />i- <br />1 <br />r� <br />C <br />L <br />2 <br />LL <br />C; <br />LL <br />LL <br />LL <br />LL <br />C <br />LL <br />V: <br />Q <br />C: <br />►A <br />SUNRISE DISTRIBUTORS <br />State of California—Environmental Protection Agency <br />Form Approved OMB No. 2050-0039 (Expires 9.30.99) <br />'Please prihl or type, Form designed for use on elite (72 -pitch) typewriter. <br />120SS993041 01 "'7/03 10:09pm P. 003 <br />See Instructions on back of page 6. Department of Toxic Substances Control <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (1/99) <br />EPA 8700-22 <br />Sacramento, California <br />UNIFORM HAZARDOUS .. '° <br />1 e�necatars US,E➢qJD Nq. <br />Manifest Document No. 2. Page 1 Information in the shaded areas <br />WASTE MANIFEST <br />`i <br />^„ is not required by Federal law. <br />or <br />3. Generator's Nome and Mailing Address � <br />' k.• <br />ASl <br />. ate Manifest Document Number nr ma <br />f•, <br />:» ::.7 •r;� ie�v ,•.. ... <br />trw <br />tryy„ a,aMsn7? rCm "ku10 :,..:n,ti rte; <br />State Generator's ID <br />A. Generator's Phone <br />n:V <br />5. Transporter 1 Company Name 6. US EPA ID Number <br />C, State Transporter's ID (Reserved.] , <br />b <br />i1 .,t4.. : r ; .•, ,., ;. :.^: S', <br />D. Trans porlar!s Phone <br />:r4 <br />g"1 <br />7. Trans orter 2 Com an Nomo S. US EPA ID Number <br />E, State Transporter's ID [Resarved.I <br />J <br />Transporter's Phone <br />9.!{larYalbTceilify NtitemSiJtSite Address 10. US EPA ID Number <br />G. State Facility's ID <br />H. Facility's'Phone <br />� <br />'''t, f <br />i;. I�.�?ll� <br />Z'.'asrPi?kfti t•9,,J7. <br />i <br />11. US DOT Description (including Proper Shipping Nome, Hazard Class, ID Number) <br />2. Containers <br />13. Total <br />1A. Unitand <br />No. <br />Type <br />Quantity <br />Wt/Vol <br />I. Waste Number <br />{.......r <br />N <br />State <br />' E <br />R <br />EPA/Other <br />r A <br />T <br />C. <br />Stare <br />i O <br />EPA/Other <br />d. <br />State <br />i <br />EPA/Other <br />t <br />J. Additional Descriptions for Materials Usted Above <br />K. Handling Codes For Wastes Listed Above <br />i <br />! <br />b. <br />c. <br />d. <br />j <br />15. Special Handling Instructions and Additional Information <br />i <br />�1JI:'. 11 f,:1 ri'' (: �I:" �y :..;.-,ti. '-. •li �l• .r. <br />. .`9:', .i. .., '.�t• `+'I t $, 'fr' i;'.fa I C!�:`•r.5 <br />?.f .r .^r .3'ia}' <br />16. GENERATOR'S CERTIFICATION: I heroby declare that the contents of this consignment are Fully and accurately described above by proper shipping name and are classified, packed, <br />marked, and labeled, and are in all respects in proper condition for transport highway to international'and <br />y according <br />applicable nations government regulations. <br />If I am a large quontiy generator, I certify that I hove a program 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 and future threat to human health <br />present <br />and the environment; OR, if I am a smaquantity generator, f have made a good Faith effort to minimize my waste generation and select the best waste management method that is <br />available to me and that I can afford. <br />Printed/Type .tVame„• Signature <br />ice'' <br />Month Day Year_, <br />_ fit _ •.r. I. 1. '1: � <br />L' ... ..,...,,.,.,._.. <br />r•' ,r' <br />T <br />17. Transporter 1 Ac nowled ement of RaEe of Materials <br />N <br />Printed/TypedNatfie <br />`"r <br />Signaturec. <br />},, <br />Month Do Yea- <br />y <br />S <br />H18. <br />Transporter 2 Acknowledgement of Recei I of Materials <br />1 <br />EPrinted/Typed <br />Nome <br />Signature °� <br />Month Day Year <br />R <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />I <br />L <br />[ <br />20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19, <br />T <br />Printed/Typed NameSignature <br />Month Day Year <br />y <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (1/99) <br />EPA 8700-22 <br />