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State of California—Envi ran mental Protection Agency <br /> ,orm 4pproved OMB,No.2050-003 (Expires 9-30-991 See Instructions on back of Page 6. Department of Toxic Substances Control <br /> Please print or form designed for use art @file(I2-pitch)ty Sacramento,California <br /> UNIFORM HAZAR OUS I. lor's US EPA ID No. Manifest Document No. 2. Page I information in the shaded areas <br /> / is not required by Federal law. <br /> WASTE MANIFItST A -[ p 'U Cl 11 L 4 U 1 ,512- 1713 4P of I <br /> 3, Generator' Name and Mailing Address A. State Manifest Document Number <br /> CFPP—LP.�_ 2004z5S4 <br /> 1100 _1•C""E 'dc 1XtT RY FCAD <br /> C-fs W,;E s Q4, 92866 B. Stale Generator's ID <br /> LO <br /> to A, Generator's Phone 1'r�(� ] ti0 E IF J 6 0 fl 7 18 6 19 <br /> & 5, Transporter 1 Company Name d. US EPA ID Number C. State Transporter's ID[Reserved.] <br /> to <br /> CD <br /> Fi 1 i e r Recycling Services. Inc.; " c ii v 4 4 1 D. Transporter's Phone t 909)873-4141 <br /> 7. Transporter 2 Company Nome 8- US EPA 1D Number E. Stale Transporter's ID[Reserved.] <br /> aF. Transporter's Phone <br /> tJ Desig ated Faciti Nome a d SiJa Address 10. US EPA ID Number G. State Fac ., G <br /> t yx �rtV1re,TlreF!�3f Y d 0 �� G [G <br /> 1,'04 ra°. First Direr=,k <br /> z.7ZU Sa. 7A 1 1)2 i_l 1_1 i 1 ri 1 'a f, H. Facility's Phone <br /> _ J <br /> 0 <br /> J <br /> 12. Coniamers 13. Total ld. Unit <br /> U 11. US DOT Description(including Draper Shipping Name,Hazard Class,and ID Number) No Type Quantity WI/Vol I- Waste Number <br /> Z aF7.Q W5, 7 E I I c`xf17y e f 1 a, Ci r F,:;lf 11 s G <br /> r:.o. _ . (gasClir,e) , 4. i , UJ13' 5, P 3 1 1 1 1'Cx1r11,13}w8) <br /> G ! 1J M 1' C4�er D01 & <br /> o N b. State <br /> co E <br /> EPA/Other <br /> 4 R <br /> A c Stale <br /> o T <br /> c O <br /> R EPA/Other <br /> w d. <br /> State <br /> r <br /> Z <br /> UJ <br /> � EPA/Other <br /> LU <br /> tri J- Additional Descriptions for Materials Listed Above �+} 4 K. Handling Codes for Wastes Listed Above <br /> Z 1 ? i 1 a0aa_,rk7EriI FR---)F I LF?t j9 i{ J a. b. <br /> g l2Cif + s 3 (� d. <br /> `1zE/UC4'. /s1' F1 / 7.�'A/l7ff't 1 �� <br /> Z 15, Special Handling Instructions and Additional Information <br /> 4 <br /> 7 <br /> 1✓A1?. PpF 51lt1P:1h 1tt�l1�:i1V t-10I'HIWi <br /> Z <br /> U1.1 4 KXR EMERt;JEIl_.Y rUVSBER. 1-0f O-721 6 <br /> = S1-FF AIRE55:2947M. rLAVE`r' DRIVE ; STC3CI,TU4 C:A 9506 <br /> = 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this cansignment are fuRy and accurately described above by proper shipping name and are classified,packed, <br /> Vmarked,and labeled,and are in all respects in proper condition for transport 6y highway according to applicable international and national government regulations. <br /> = If I am a large quantity generator,I certify that I have a program m place to reduce the volume and toxicity of waste generated to the degree f have determined to be economically <br /> N practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future 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. 1: <br /> >. Printed/Typed Name SignglurE .. { Month Dap Year <br /> Z _ <br /> T 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> w la Printed/Typed Name Signatu Month Day Year <br /> LU <br /> rr- 0 1 S. Transporter 2 Acknowledgement of Reeei i of Materials <br /> C) R Si nature Month Day Year <br /> 1 Primed/Typed Name g <br /> ru f - . . - .... *.4 r, <br /> R <br /> Q <br /> V 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> ( 20. Facility ner or Operator Certification of reAlt of hazardous materials covered by this m ifes ce as in ll 9. <br /> = Printed/T Name Signature <br /> 60 <br /> Da <br /> Y <br /> r. <br /> DO NOT WRITE,$I:UDW THIS LINE <br /> Yellow: TSDF SEND6 <br /> TH6S C.PY TQ GENERATOR;WITMNI 30 DAYS <br /> f2A{}/99] (Gegorators who submit huzbrdous waste for transport out-of-sfateY <br /> MC 8022A <br /> EPA 8700-22, produce completed copy of this copy and send to DTSC wifbin 30 6ys.) <br />