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t URI DEPARTMENT OF NATURAL RESOURCF% <br /> INSTRUCTWN'S FOR THE COM- Division of Environmental Quality =EMEM�CYR�PONSEESPONSEPLE'ION OF HIS FORM ARE ON A Waste Management Program GUARO-81102 <br /> SEPARAT HEET. EETHI OCUMENT MUST BE USED P.ORO% 176 Jefferson City, Missouri 65102 EC314-751-3176 'NRES300 <br /> FO ALL MISSOURI-DESTINED RESOURCESSHIPMENTS HAZARDOUS WASTE MANIFEST 436 <br /> Form Approved.OMB No.2050-0039,Expires 9-30-91 <br /> Please prim or type (Form designed for use on elite(12-p00)typewriter) <br /> I Generators US EPA ID No Manliest 2.Page_� Information in the shad4areasUNIFORM HA2AR DOUS No of �_ is required by State law <br /> WASTE1 70 09 Ne@lark Sierra Paperboard A.Missouri Manifest Document Number3.Generator's Name and Mallin Address <br /> 800 W. Church St. <br /> Stockton, CA 95203 B.State Generators lD-other <br /> o.Generator's Phone t 209 1466-5251 <br /> 5.Transporter t Company Nam¢ 6 US EPA ID Number C.MO.Trensponer's ID (L <br /> FALCON ENERGY ASSOCIATES A D.Transpo ars Phone — — M <br /> ].Transporter 2 Company Name 6.US EPA ID Number E.MO.Transporter's o CA 253 12 a <br /> F.Transporters Phone 314-35'-55 <br /> O <br /> THE KIESEL COMPANY I <br /> 9,Designated Facility Name and Site Address 10.US EPA ID Number G.State Facility's ID r <br /> THE KIESEL COMPANY RRO124 U <br /> H.Facility's Phone <br /> #i Branch St. <br /> St. Louis, Mo. 63147 3 4- 5 -1 <br /> 12.Containers 13_ 14. <br /> 11.US DOT Description(Including Proper Shipping Name,Hazard Class.and iO Number) Total Unit I.Waste No. Z <br /> Quantity Wvvol. ty <br /> EPA WASTE CODE cc <br /> a Waste Combustible Liquid, N.O.S. NA ca 221 Z <br /> (Waste Oil with solvent contamination ) NK 1993 O I rJ O ¢ <br /> G <br /> EPA WASTE CODE O <br /> E b. <br /> N (� Fn <br /> E a Yn <br /> R <br /> EPA WASTE CODE <br /> A <br /> T c <br /> O <br /> R <br /> EPA WASTE CODE <br /> d <br /> K.Handling Codes for Wastes Listed-Above <br /> J.Additional Descriptions for Materials Listed Above <br /> Waste Oil and Stoddard Solvent <br /> a W is <br /> 0 <br /> b. Z R <br /> C7 <br /> o' OnW <br /> d. - W Z <br /> DE ��7 X <br /> 15.Special Handling Instructions and Additional Information W <br /> XW <br /> f 2 <br /> 24 HOUR EMERGENCY RESPONSE # 1-314-421-0328 (THE KIESEL COMPANY) . > ~ <br /> M> <br /> 16.GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, marked.by highway according to applicable for transpo <br /> in all Q CC <br /> and Iatai and are respects m propercondition rt international and national government regulations and applicable state regulations <br /> LL <br /> II I am a large quantity generator, certily Inst have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined 1p be economical) practicable ¢LL <br /> and that l have selected the practicable metM1od of treatment,storage,or disposal currently available to me which minimizes the present and Mature threat 10 human heath and the environment, <br /> OR,if 1 am a small quantity generator.I have made a good faith effort to minimize my waste generation and 1 the best waste management method available m me that I can afford <br /> Day Year W a <br /> Printed ped Name Signature l / B <br /> 'U U <br /> Date H U <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials V Month Day Year o F <br /> R signal ll`` <br /> 5 Prince yam{ c\\ �c7M¢ I V I U <br /> P Date M�,li <br /> R 16,Transporter 2 AcknowleOgemenl of Receipt of Malon"s Month Day Year F <br /> Sig tu I H 1 <br /> T Prinled/TYped Name W <br /> E U)< <br /> R I ku <br /> 19.Discrepancy Indication Space m 1 <br /> F N I <br /> A <br /> f <br /> 0. <br /> L 20.Facility Owner or Operator:Certification of receipt of hppa ous teriat$ er y Ihis}Qenifesl except oled i 19_ Dale 0 <br /> T Signature Month Day ar.N <br /> Y n d Nam <br /> H <br /> EPA F in 87 - (Rev.9-88) MDNR-HWG 10 P EVIOUS EDITIO S ARE OBSOLETE <br />