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State,of California—Environmental Protec"m Agency See Instructions on back 0 ge 6. 8apartment. Tl oxic SI,6, aces Con
<br /> Form Approved OMB No.205x0039(Expires 9-30-991 Sacramento,California
<br /> Please print or type. Form designed for use on alit,(12-pitch rifer.
<br /> 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 In6realion in the shoded areas
<br /> UNIFORM HAZARDOUS is net required by Federal law.
<br /> {HASTE MANIFEST A It In -71 5 1 8 14 17 12 =t 2
<br /> A. Slate Manifest L) Number ^/� ^ s
<br /> &GenerssWr'PNa a qpd 00 LlegRsstLddre5s-s7� L L („f
<br /> IDs Le OL 5t, !I
<br /> 1905 Aston Avenue B. Stale Generator's ID
<br /> o Carlsbad, CA 92008
<br /> 4r) 4. Generator's Phone 1800 I 451-8346
<br /> n C. Slate Tmns odei s ID(Ras=rved.1
<br /> N 5, Tronsparter 1 Company Name 6. US EPA ID Number P
<br /> h
<br /> ag
<br /> D. Transporter's Phone
<br /> o Pollution Control Industries CAR 0 0 0 0 8 8 7 3 2 (916)351-0980
<br /> E. Slate Trans mar's ID IReserved.l
<br /> CP 7. Two, O.r 2 Company Name 8. US EPA ID Number D°
<br /> iMti Q y V/�� � F. Transporler's PAene �1j-
<br /> V (�M-E`� 10. U$EPA ID Number
<br /> G. State Faci iy's ID
<br /> 33 4a ignoted Facili Name and Site ddrev
<br /> Q Yol�ution �ontrol lndustriee -
<br /> LOZ 4343 Kennedy Ave H., FaaiBty'e Phone
<br /> COO East Chicago, IN 46312 IND 0 0 0 6 4 6. 9 4 3 (219)397-3951
<br /> A e Q '-• 12. Containers 13. Total 14. Unit
<br /> V 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number! No. T e Quantity Wt/Vol 1. Waste Number
<br /> Z I a. , waste m
<br /> 2ma a "qua s, n-o_5 Stat. 343
<br /> (methanol, toluene) , 3, UN1993, PGII (ROF-D001) .EPA/Ot r
<br /> 3 G 01013 1) M P 001
<br /> 6i Estate
<br /> b, waste corrosive "qu" s, ac" "c, anorgan"c, 781
<br /> 00 E n.o-5 (hydrochloric acid, sulfuric acid) , 8, P EPA/Oi15002
<br /> R UN3264, PGD II (, e.(�aZl 1 P
<br /> Ac, waste COrr09"IIC aqua s, asac, anorgaaac, state 122
<br /> TO n-o.s (sodium hydroxide, so aEAm hypochlorite) , P EPA/Ot�002
<br /> R 8, UN3266, PGII (_Qt3'Ate 2—) O 1 Dir
<br /> state
<br /> Z d'__Tar.TT �'
<br /> EPA/OI
<br /> w
<br /> V
<br /> Ad Desc f r L sl K. Handling Codes For Wastes b. Above
<br /> Z ) �'t(f , L"i74S5; "19b'2� ERG#128-b) W3#6 ERG#159 c) (/j b.
<br /> O W9#7 ER9#154 d) W3#2 ERG#151 a
<br /> a) *3x65DM c) 1X 30aF c d
<br /> b) EX IyAF d) 144 SIi1Pl'l . ,..
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<br /> o 24 ielt�^ ctG�ieeY d 97 Y§E 'e800)388-7242 GA egs330 t
<br /> Site Address:'710 b"AZ Confirmation# �( PPro 0521# 20(OR'S
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<br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this comignment ore fully and accurately described above by proper ship Ing name and are classified,packed,
<br /> Q marked,and labeled,and are in all respeos in proper condition for transport by highway according to applicable international and nalionaPgovernment regulations.
<br /> r IF I am a large quonrip generator, <ertiFy that I have a program in place ro reduce the volume and roaiciry of waste generated ro the degree I have determined to be economically
<br /> a pr ctkable and that I h ve selected the practicable method of treatment storage,or disposal currently available ro me which minimizes the present and future threat to human health
<br /> h and the environment;OR,if I am o smolt quan8ly generator,I have mode a good faith effort to minimize my waste generation and select the'best waste management method that is
<br /> a' available to me and that I can afford.
<br /> O Printeceyo No ('2 Sign.w. Month Day Yea
<br /> w T 17. Trans her 1 Acknowled emenl of R cei t of Materials
<br /> ()r Month Year
<br /> d' A Prinrod/Typed Name Si lure ��
<br /> w
<br /> w S Q
<br /> w a 18. Trans orter 2 Acknowled .marl of Recei r of Materials Month Day Yeo.
<br /> W j Printed/Typed Name
<br /> ywj E /I G¢N ,Cj jF/LR.L3 LV—•
<br /> A
<br /> kaj 19. Discrepancy Indication Space
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<br /> A
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<br /> 20. F cili Owner or rotor Certification of recei 1 of hazardous materials overs' this manifest ezce It os n 19. nth ay�•.eea_
<br /> T fin d Typed Nama/ / $ig a re {O�
<br /> Y sal/
<br /> DO NOT WRITE BELOW TH
<br /> White: TSDF SENDS THIS COPY TO DTSC,WITHIN 30 DAYS.
<br /> DISC 8022A(1/991 To: P.O. Be- 3000, Sacramento, CA 95812
<br /> EPA 8700-22 - -
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