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JUL-10-2006 10: 13A FRON:C R I RE L'I^NG 7156983485 T^' 19166892003 P.2 <br /> Stare of California—Environmentol Protection Agency <br /> Form Approved OMB No.2050-OC39 IExpiras 9-30.941' See Instrudic— I bcdc t]f5, <br /> Y Decarfmenf of Toxic Substances Central <br /> Please print or type. farm designed for use on elite(i2-pitch)typewriter. - Sacramento,C:li'I;a-- <br /> r UNIFORM HAZARDOUS I Generator's US EPA ID No, Mcnefasl D—manl No. 2 Page I Information In the shedad areas <br /> is not required by Federol law <br /> S WASTE ;MANIFEST � � E al I <br /> 3. Ge tori Name and M Ad re s A, Stale Manifest Dosurnanl Nu miser <br /> 24 4 3 <br /> B. Sieh Generator's!Din <br /> ! J <br /> v} A. na or s Ph e <br /> n <br /> CN 5. Transporter i Company Nome 6. US EPA ID Number C. 5rnte Transporter's ID Ressrvad.l <br /> Q0 <br /> as � <br /> C3 ,I I D. Transporter'% one `�jn]� <br /> Q , r V <br /> 7. Transporter 2 Com any Name 8. U5 EPA ID Number E, Slate Transporter's ID lResnrved.� <br /> T, <br /> aF Transporter'%Phone <br /> _lJ 9. Demgnatad facility Name and Sita Addpss W. US EPA ID Number G. State Facility's ID p <br /> a � 1, uCsL If <br /> :aZc <br /> aN,�� <br /> H. Facility's Phone <br /> 'OU I o- <br /> +a I I. US DOT Description lincludNa <br /> ing Proper Shipping Name,Hazard Class,and ID Number) o. TypContainers 13.e Quannttaf IA. Untr <br /> No. W1/Vol I. Waste Number <br /> a. State <br /> 2 <br /> r <br /> 3 EP /Olh r <br /> f= — <br /> O N b Slots <br /> to <br /> R This Copy is Your EPA/O+her <br /> A CEFff IFIGATE - . <br /> c. stale <br /> T [J� %CYCLING <br /> o2R .EPA/Othtr <br /> K (� <br /> W d. I Stale <br /> 1-- <br /> Z Z <br /> W <br /> � EPA/Other <br /> w <br /> 'n J. Addiiianunl D»escYrnpl�ions for Materials Listed Ab t „(� K. Handling Codes For Wasras Listed Above <br /> L } 1 <br /> W <br /> d. <br /> 15. e k4 ql Hondli strutnans and Additional Inkrmorio_ f ' <br /> Sp V�JCj_ !�1/tP1`Lj��YI Ln/� t/�C�yJ//,•!{'{,resit 'L° `iP.r^, ( D`�)C {`- % [pqI I % <br /> T J J ,., �I <br /> ti -QfA <br /> 15. GENERATOR'S CERTIFICATION: thereby declare that the cantenp of this tonsi©nman era fully and a curetaly described above by propar shipping name and are classified,packed, <br /> Umarked,and labeled,and are:a oft respects in proper condil[on for transport kiy hig way according to applicable mtamabonol and notianaf government reguletiam. <br /> If I om o large quanliFy genaralor, I certify that I have a grogram to piaci to reduce the volume and tasctuly of waste ganmrated to the degree 1 have determined to be economically <br /> d prccticn61s and That I f ova selected the practicable method of treetment,storage,or disposal currently available!a ma which minimizes the present and future threat to human health <br /> I <br /> and the environment;OR, if I am a smo I quantity generator, I have made a goad faith effort to minimize my waste generation and select the bast waste management method that is <br /> available to ma and that I can afford. <br /> 0 <br /> } Printed/T art {pmo Signet Month Dao�rt <br /> W T 17 from ortar I Acknowled ement of ■i 1 of Malerials <br /> A tint. T per Name Signature M70Q, _Yea <br /> W P <br /> �+- 0 18. Transporter 2 Acknowledgement of Rocei %of Maleriols <br /> Q T Printed/Typad Name Signalure Month Day Year <br /> LLj tri E f. <br /> Q R <br /> V 19. Dixrapancy In.icorian Spec. <br /> z F <br /> A <br /> C <br /> I <br /> I <br /> 1 20 ol:Ity Owner or Operator CartiRcation of races r of haxardous matariols covuad by this anifest except as noted In Stam 19 <br /> T Ind/.T1,.*d Name Sign r oaf Doy Year <br /> DQ NOT WRITE BELOW THIS LINE. <br /> DTSC 0022A 11/991 <br /> ia.. „7:C :c: <br /> EPA 6700-22 <br />