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Smro of Calif ornia—En✓ronmenml P,.te,f on A9 ry •
<br />Form Approved OMe No. 2050-0030 (P ¢ Sea Inafructions on back of ,�e 6. Dna bstaw
<br />epamanttoxic Sune Control
<br />.1- a int or a Farm derigned for np; , b2 plrahj ypeWitter, Socnomerl.. C.Illarei.
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<br />UNIFORM HAZARDOUS
<br />1. Gen....., s US EPA ID No. Manifest DocumQam No.
<br />2. pogo L s em aegeirodtby F� rel N�t
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<br />WASTE MANIFEST
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<br />]. Generaror'e Nome and Mailing Addra>;/J
<br />A. SlaManit Deal Number
<br />23799917
<br />a� �rti j
<br />Generoto"a ID
<br />A, Oenelaor's Phone b•C•IE F�'.y5 " l /T l?Js<, r'r�lt.;�: CacaF.f'�'t/,✓�
<br />�a,RIIJt�Ar 6. US EPA ID um6e!
<br />C. StateTnmpprter's ID IR..ened.l
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<br />D. Tnsm,,atyr•i Phan.
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<br />TronlpoYi ID ( I
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<br />F. Tramped,,'' Phony
<br />�q.lnewwp a ort Atli s 10. US EPA ID Number
<br />G. State Focility's ID
<br />ttl li31(I.Y, NST ILW)1 N V 11 :1 fi Q 8 9 3 3 8
<br />N. Faellly! Ph e
<br />11. US DOT Dewriplion (including Pnei Shippi g Nome, H6zard Clot, and ID Ni
<br />12, Containers
<br />13. Total
<br />Q n(m6l
<br />U. Unit
<br />Wi/Yol
<br />I. Waits Number
<br />No.
<br />Type
<br />VLO-aot -j 1
<br />Stow
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<br />EPA
<br />NSorts
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<br />,Il�ddr'ayol0 �s fat lr ' L I.I.A o f Tlo v" G 1, (''QS,jt �� ( N. Handling Coda for Watt. lined Above
<br />Ito 1O�� a. 6.
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<br />15. Special Handing lranr .tions and Additional information 11@ }
<br />94 MUT Sr1!17ctd MCY (XATAt-r-FiV M KXN 0U.. 610 4W-4)I2f{ 11b
<br />WEAR 00010ft.V9 (UITNTM h Td VI(Alt G1'11i:. HVRG t.la,
<br />16. GENERATOR'S CERTIFICATION: hereby declare that the contents of Chia conegnment arc fully and ouerotely deurihed above by proper shipping name and oy dasrihed, packed,
<br />in itfon for tromped by hmhwoy.,,.,ding Io appliaoble international and nas.mol government regelonone.
<br />mark.d, and Iob.led, and ore in all ry.peeH proper,,m
<br />If I am o log. quantity generoyr, I e.rRfy the I have o pragrom in pi... m redae. the volume and Iexiciy f vane gmerotsd to Nw degree I hove determined to be aeonomieallyy
<br />and thot IT-,- solectsd the pronico6l. method o t—, --at, "rage, or di.pasol eurr.ndy evailoble m me whieh minimizes the Pm --At oad future threat to human 1`0011Kand
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<br />pcKco6le
<br />the environment; OR, if I am a small quonliry generator, 1 have mode . good faith ,(fort to mm mi. myste g.rareefe. and select the ben wool. monogem.nt method that ie
<br />available no me and that I can afford. 17
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<br />17. Trans nAcknowle mem f Racei of Motsriols
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<br />Prinwd/Ty e /
<br />5ignohrro fY. �"` �'
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<br />s arter 2 Acknowled .mem of Reeei t of Motsrials
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<br />1
<br />Printed/Typed Name
<br />ignomre
<br />Month Doy Year
<br />19. D;,er ne, Indication $9.1.
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<br />20. F.eility Owner or Operator CerNfieaion of re,ei t a haeardoae moyri.lc covered by thin manifest except os noted in Item 19.
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<br />Printed/Typed Name Signmure
<br />Month Doy Year
<br />Y
<br />DO NOT WRITE BELOW THIS LINE.
<br />OTSC 0022A (1/991 Yellow. GENERATOR RETAINS
<br />EPA 0700-22
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