Laserfiche WebLink
` Agency <br /> 9o-991 See It�stru'lRans <br />! 11 <br /> ,g„ed9f rse on elite f I2�ritd+l "iter. •• H 1 yr.+ t +- _ e• .r <br /> i 7-4: -Se detttirtiri,CoFefon+id::- <br /> 1�IFGRM HAZARDOUS 1' rtemror s US EPA ID No. :INasrifest Doeamerd No.,:`::.� '..2 tPage 1 ierforrrratiat;n the sltraded `'' <br /> WASTE MANIFEST A 4 Ot O 3 1 '' n twt r.garnd fedwa!!aw <br /> 3. GeneraMl Name a d Jin A tress n r `~ <br /> ' TUFF BOP L�:A�NIG ' .I <br /> !51 E. ALMOt+InWOQD DP. . MANTECA, CA' 95337 <br /> n w M <br /> w1j A. Getreitrtar's Phone r:.ff'�.1235-1361 Cr 5. Trans�orlrr 1 Com ny Home 6. US EPA ID Number. <br /> Go �3E' .AL D l�L ALS '� B2 4 17 2' 515 <br /> I! } <br /> r. 7. Transporter 2 CompanyName <br /> B. US EPA ID Number <br /> J ' <br /> I(L US EPA iD Number <br /> Jz 17CJO S. SQT,&—ST. <br /> a0 !DS. AN BILES, CA. 90023A O �� 4 5� 7 <br /> Q 3 Containers V 11. US DOT Description{including Proper Shipping Nome,Hazard Class,and ID Nt[m!xr) 12. 13. Total 14. Unit <br /> No. T Ouantity Wt/val <br /> Z NOfu—PCrRA HAZARDOUS WASTE L I QU I D <br /> 3!= G . (WATER & SLUDGE) 0'. 01.E LL <br /> ©C�C3 <br /> o H b. <br /> m f <br /> 4 R <br /> m O c <br /> a <br /> z '1 <br /> V) - - - <br /> o r <br /> Uj <br /> lti e <br /> J <br /> Z 15. Special handling Institutions and Additional Inforrnotion <br /> O - - <br /> a <br /> APPROPRIATE PROTECTIVE CLOTHING - <br /> I Z "EMEPGEsr'CY CONTA T: r2OS)541-9145" <br /> z BEE E.R. G. 171 <br /> .J. 16. GENERATOR'S CERTIFICATION: I hereby dedore that the contents of this tenet ment arc Fully and acwratel!y�''desoibed above by pmper shipping name and oro classified,packed; <br /> Q marked and labeled and are in all res in condition for hi h according to applicafsle inhrmatlorrol and rrafiorre[government roBalations. <br /> h gs mit l g way <br /> I I� Pr�r � .. <br /> IF I am a large quanNy generator,I certify tfwt 1 have a in place to rerluce the vofume and toxicity' nF waste genw+rt 4-t.the.d�rx I have dale-mined to Ea acartwn o!}y . <br /> practicable and that I have selected the prachopbie method of treatment,stomge,or disposal currently ovoilable to me which�•7/,"s-,,•inimizes the present and future threat 16 human Freolr} <br /> and the environment;OR,if I am a snm II quantity generator,1 hove mode a good faith effort to minimize rriy waste eneroMatr and select the hest waste management method that is <br /> avoikdAe to me and that I can afford. `!! r <br /> } Printed/Typed Signonrre. r tYlorrth Day �eor <br /> z / 4 <br /> ua T17. Trans 1 Acknowledgement of Receipt of Materials Ay <br /> R <br /> LU A Printed/Typed Name J . 1 .� Signature _ � f month ^Day Year <br /> P _ <br /> of Receipt of Materials - f 1 <br /> u- 18. Trans r 2 Acknowledgement <br /> tl <br /> R Month Yaw <br /> Nam <br /> S npture ' <br /> I <br /> Printed/Typed No rg - <br /> LF ,u E <br /> OPrin <br /> F a R <br />' r V 19. Discrepancy indication Space <br /> Z f <br /> L <br /> 1 20. Fnatty Coner or a Certif" ria i receipt of hazardous materials severed ivfncmiW exce s 6oWdin Item 19. <br /> 7 Prinp Name Signatu� 1' _ Man 'Day Yep <br /> Y <br /> DO NOTE I ELOf(-THIS LINE. . <br /> ....'k- <br /> 4 DTSC 8022A(4/97) Green: TRANSPORTER RETAINS <br /> I EPA 8700-=22 - <br /> i <br />