Laserfiche WebLink
3 <br />a <br />7 <br />rorm Approves ume No. 2VDV 039 Expires 9-30-99) <br />Please print or type. Fersil designed for use on ./ire 112.pitch) haewrilar. <br />See Instructions on back of page 6. Department OF Toxic Substances Control <br />DTSC 8022A- (1/99) <br />EPA 8700-22 <br />DO NOT WRITE BELOW THIS LINE. <br />Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />To: P.O. Box 400, Sacramento, CA 95812-0400 <br />UNIFORM HAZARDOUS <br />1. G is US EPA ID No. Manifest Document <br />Page 1 <br />Jacrcmdnto, California <br />Information in the shaded areas <br />WASTE MANIFEST <br />is not required by Federal low. <br />CAD 9 8 2 0 5 2 7 6 3 2 4 2 9 3 <br />of 1 <br />3. Generator's Name and Mailing Address <br />A. State Manifest Document Number <br />DELICATO VINEYARDS <br />9r;1 0 7 4 2 5 <br />S. HIGHWAY 99 <br />B. Slate Generates, s ID <br />'t <br />�1,�2yy0�0r1p <br />953136 <br />M.'rSRihldldPlrPho _ <br />894 <br />5 Trampomn 1 Company Name - 6. US EPA ID Number <br />C. Stara Transporter's IU [Reserved.] <br />SHOP HAZARDS SOLUTIONS ClAl01 0101 0 6 4 6 4 91 7 <br />ns <br />D.-Traports/s Phone <br />- <br />7. Turns ler 2 Com Name800) <br />P°f Company 8. US EPA ID Number <br />2415-7649 <br />E. State Transporter's ID Reserved <br />po [_ ] <br />( <br />F. Transporter's Phan. <br />9. Designated Facility Nome and Site Address 10. US EPA ID Number <br />G. State Facility's ID <br />GEM—RANCHO CORDOVA, LLC. <br />118S5 RHITE ROCK RD. <br />RANCHO CORDOVA., 17A Q.;?4-? I Cl Al ni 91 Al 01 81 81 41 1] 111 -Il <br />H: Faciliy/sPh... <br />tairlblKi— 19FUn <br />C <br />11. US DOT Descri tlo <br />p n(iwdyding ProperSbipping Name, Hazard Class, and ID Number) <br />12. Containers <br />13. Total <br />14. Unit <br />No. <br />Type <br />— <br />Quantity <br />Wt/Vol <br />I. Waste Number <br />a Neste Aerosols, flammable,Sta <br />(each not exceeding <br />te 331 <br />1 L capacity) , 2.1,UN1950, _ _--_-- <br />EPA/01ber. <br />-E- <br />o o <br />D <br />-- --' <br />_.. <br />r <br />i E <br />OILY RAGS <br />Slates <br />R <br />NON—RCRA HAZARDOUS NASTE SOLID <br />223,352 <br />EPA/Other <br />A <br />01011 <br />010121 10 <br />P <br />-- _ <br />T <br />—Dili <br />State <br />O <br />_ <br />EPA/Other <br />R <br />d. <br />store <br />EPA/Other <br />J. Additional Descriptions for Mot.,W, Listed Above - <br />K. Handling Codes for Wastes Listed Above. <br />a) PROTILE #R8663, MISC SPENT AEROSOLS, ERG #126 bj <br />b. <br />PROVILE`#R6606,ERG`#171 <br />_ <br />d. <br />15. Special Handling Instructions and Additional Information <br />APPROPRIATE PROTECTIVE CLOTHING <br />"EMERGENCY CONTACT: (800) 746-744911 <br />16. GENERATOR'SCERTIFICATION: I hereby declare that the contenh of this consignment are fully and aOcprandr described above by proper shipping name and are classified, packed, <br />- marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br />If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity OF waste generated to the degree I have determined to be economic 11 <br />practicable and that) 6Gave selected thea treatment, storage, or disposal future <br />practicablemethod currently available to me which minimizes the present and threat to human health <br />and the environment; OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br />available to me and that I can afford. <br />Printed/Typed Nome ' <br />Signator <br />Monts Day Year <br />b b 1s b <br />' N <br />I Z iron iter 1 Ac4now6d em.nt of ffeadlpf of Materials - <br />A <br />R <br />Prinled( ped Name <br />Signature <br />Month Day Year <br />P. <br />x <br />�r <br />h..[. <br />- B <br />1 B. Trans her 2 Acknowlad emenf of Recti t <br />".R <br />Printed/Typed Name <br />Signature <br />Month Day Yoe, <br />E. <br />R <br />19, Discrepancy Indication Space <br />F <br />A <br />I <br />L <br />1 <br />20. Faclli Owner or Operator Certification of recei t of hazardous materials <br />covered b this manifest except as noted in Item 19. <br />T <br />PrinNd/TypedName <br />Signature <br />Month Day Year <br />Y <br />DTSC 8022A- (1/99) <br />EPA 8700-22 <br />DO NOT WRITE BELOW THIS LINE. <br />Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />To: P.O. Box 400, Sacramento, CA 95812-0400 <br />