Laserfiche WebLink
Sale of California—Environmental Protection Agency lJ W <br /> Form Approved OMB No.2050-0039(Expires 9.30,99) See Instructions on bock We O. Department of Toxic Sub0onces Car <br /> Please print�Iype. Folin designed For use on elite f72-pltc v-mr' 698529 Sacramento,California <br /> UNIFORM HAZARDOUS <br /> 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br /> WASTE' MANIFEST 5 1 1 5 9 of 2 is not required by Federal law. <br /> 3.kieneralor's Ncme and Mailing Address A. Stale Manifest Docemwo Number <br /> HOME DEPOT #HD5576 HOME DEPOT C/O 3E COMP 24783701 <br /> 0 701 D'ARCY PARKWAY 1905 ASTON AVENUE #100,& State Generator's ID <br /> W) 4. G-LATHROR CA 95330 CART SBAD CA 92008 <br /> NS. Transporter 1 Company Name <br /> Q71 6. US EPA ID Number C. State Tronsperter's ID IReserved.1 <br /> 0 D. Transporter's Phone - <br /> 0 21st CENTURY ENI CAR 01010111614101112 ; (877)748.394 <br /> �^ 7. Transporter 2 Company Nam, B. US EPA 1D Number E. State Transporter's ID IR,,mved.1 <br /> ®a3 L l c-5 11)T O ) <br /> -116911. ironspo er's Phone n y <br /> I`U 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Faciliys ID U�9 <br /> C�DQ 13URI.I mON ENVIROZRENML, INC. KENO' <br /> �W20245 77TH AVENUE SOM H. Fodiliys Phone <br /> WKENT, WA 98032 1 NI Al 11191 111 �1 R1 I 1 -71 Al 7 <br /> V (25 1 A71 RA14A <br /> 11. US DOT Description(indudino Proper Shipping Nome,Hazard Class,and ID Number) 12. Contains,. 13. Total 14. Unit <br /> No. Type I Quantity Wt/Vol I. Waste N tuber <br /> zState <br /> X a WASTE AEROSOLS, FLAMMABLE, R.O.S. 2.1 UN1950 LTD QTY ERG0261 DF !!�^sIr <br /> 3 G a V P EPA/Other 0001 <br /> b. <br /> 7� p� N sat <br /> J m ]( . <br /> N R PGII 'TOXIC' ERG(153) I p M I I I I PD00EPA/Oth6p6 ' <br /> y�v A <br /> J 6 T <br /> a0D O , A/Other. .. <br /> 1 R 0112588 PGII ERG(151) D H P .-,- -DOOR . <br /> ads d. state. <br /> Z X WASTE CORROSIVE LIQUID, BASIC, INORGANIC, N.O.S. (SODIUM <br /> HYDROXIDE, POTASSIUM HYDROXIDE) 8 UN3266 PGII KRG(154) D F P EPA/O her"�e2 <br /> W <br /> ZJ. Additional Dsscriptiona for Materials Listed Above K. Handling Codes For Wastes Listed Above <br /> 2 a► 110132.1-110115 0117 0118 0135 - AEROSOLS - INC12 (1) b)'1101(96.11,41 DIOR b: <br /> W 0111 0116 331 - TOXIC (LIQUIDS ONLY) LOOSBPACI - I1CA AF06 (2) c) HOMEPEST-11 <br /> DOOR 0811 D115 PB11 P112 PAR 0248 - FERTILIZERS WITH PESTICIDES LOOSEPACI - d. <br /> Z INC111 3 1111016811-11 WSC2 - ALIALINE CORROSIVE LOOSEPACI - INC14 4 <br /> O 15. Special Handling Instructions and Additional Information \. <br /> PROPOSALI: 47317 24 HOUR EMERGENCY CONTACT: (818) 451-8346 X14) (ln11/{2-5X/ <br /> Z <br /> ud)un'i if z�SX <br /> W <br /> H <br /> J 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this carnigmmens are fully and accurately described above by proper shipping name and are classified,pocked, <br /> Vmarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and notionol government regulations. <br /> J IF 1 am a large quantity generator,I certify,that I havwo program in place to reduce the volume d lodeity of waste generated to the degree 1 have determined to be economical[ <br /> a- practicoble and that I hove selected the yyradicable method o treatment,storage,or disposal re ly ovoilable ro me which minimizes the present and Futere threat ro human health <br /> N and the environment;OR,if I am a smo I quantity generator, have <br /> made a good faith eN to m' imfz my waste nera8on and select the best waste management method that is <br /> available to me and that I can afford. <br /> } Pince /Typed Name s Signature Mo 1 Day Vear <br /> Z IL.1 ..4 <br /> W T 17. Transporter 1 Acknowlodgement of Receipt of Materials Ll <br /> (7 <br /> sds, p d/Typed No Si Man h Day Year <br /> W S <br /> u rn 2 8' <br /> u- 0 18 ran$ ner 2 know[ed ement o1 Receipt of Materials <br /> O R rin'teil ma/ azure Month Day Year <br /> Q R <br /> V F 19 Dis'Nponcy Indication Space <br /> Z A <br /> C <br /> 20. Facility Owner or Operator Cert'cation of receipt hazardous materials covered by t manifest except o noted In Item 19. <br /> T Prtnted/T d Name Signature Month Day Year <br /> Y / c <br /> DO NOT WRITE BELOW THIS LINE. DEC 5 AM11.4$3 J <br /> DTSC 8022A [1/991 - White TSDF SENDS THIS COPY 't0 DTSC WITHIN 30 DAYS. <br /> EPA 8700-22 <br /> To: P.O. Box 3000, Sacramento, CA 95812 <br />