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Form Apprp,iia l)M8 No 2060---OWS?(Eipaea Q-30-5I) p 'ualancos Co 1(01 D�vuro� <br /> see I w f typo. O."d.alpn.d kY a"on RIVitah op~*.d. 7-185-01 Caewarnento,Californir <br /> UNIFORM HAZARDOUS W 1]aararatrxa us EPA ID Na Dom t. Pap. I fetormatloa w ttlf 1Madad area. <br /> WASTE MANIFEST of 1 1 Is so regrrMad by F*ftml late. <br /> S. Generator's Name and Malling Address A. Stisle <br /> VALEY LGRRNERi� PLNT T p ' <br /> R��� CA 91l6h LOX 108 w <br /> ~' <br /> Y., ,,• <br /> 4. genesatar's .2Tq4— 3 1 � -`• <br /> 6. Transporter 1 Company Name e. US EPA K) Number C, state T e}Lkit <br /> P, SAEETY_ • c <br /> N <br /> 7. Transporter 2 Company Name e. US EPA 10 Number E Staff TfinlpoAar'D= <br /> � - Trar►aportfr'1l _ ..,� t r � ,c. <br /> D. Designated Facility Name and 341a Address 10. US EPA ID Number B. &ds Farr <br /> IC'TY C P. 7-185—+01 A; <br /> AL Am L `` <br /> '� Sf�l.. FL FadYty'sPh�L as n �3'.' I <br /> AI t n4 ri ¢ _ <br /> 12. Containers 13. Total 14. 01 <br /> LL t 1. US DOT Description(Including Proper Shipping Nome,Hazard Class,and IO Number) Ouantlly UnJ4 iat*No. <br /> No. Type <br /> ET13 <br /> ?) z U G C,QMBVST BL'— LID U N55=01 ? tERG #27a DM P <br /> N <br /> kA10their <br /> n <br /> pa <br /> E b. <br /> A <br /> T <br /> N O <br /> R c. ts• <br /> f <br /> a. NOTICE: IN AC Oft WITH 4 2�g 7, HE A OR R 1 ice <br /> THAT THE WA87 R $LD AS PETR <br /> v <br /> ��RSTRICTED W;A THE WASTE GL1�V�A .NIS <br /> . <br /> a. <br /> 14.1 <br /> ... f r}f'` -+� .'fie .�t, r,�xi g'.,O S. i' O. •Y ,}� F• ,. <br /> 16. Special Handling Instructions and Additional Information <br /> _ "17 14911448 08'0940 7-1'85--81--3077 01 <br /> z EMERGENCY RESP#1-748--88@-4660 <br /> J SKDOT# A: 301 8: C: D: <br /> J <br /> < t e. <br /> U <br /> J GENERATOR'S CERTTFICATiOW I hereby declare that the contents of this consignment are fulty and accurately described above by proper Shipping name <br /> and are classified,pecked, marked,and labeled,and are in all reaped■in proper condition for transport by highway according to applicable international and <br /> S national govemment regulations. <br /> rr7 <br /> M I am a large quantity generator.I certly that I have a program fn place to reduce the volume and toxicity of waste generated to the degree I have determined <br /> to be economically practcable and that I have selected the practicable method of treatment,storage,or disposal currently available to me whlch minimizes the <br /> Present and future threat to human health and the environment;OR,N I am a smart quantity genaretor.I have made a good faith effort to minimize my waste <br /> (� generation and select the best waste management method that is available to me and that I can afford. <br /> iia Print d deme lure Month Day Year <br /> 0 <br /> w <br /> WT 17. Transporter t Acknowledgement of Receipt of Materials <br /> 2 R <br /> z A PrintedrTyped Name Signaluro Mon 08* Y ar <br /> " <br /> S Noel Thorntom <br /> LU P <br /> w O f8- Transporter 2 Acknowledgement of Receipt of Materials <br /> U T PrintedrTyped Name- �gnatur♦ Month Day year. - <br /> E r <br /> Z_ <br /> 19- Discrepancy indication Space <br /> F <br /> A <br /> C <br /> I / <br /> L <br /> I 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manife t except as rated in Ilam 1g. <br /> y PrintedlTOd� e s 5gnatur c fh aY <br /> DhtS 8022 A(1188) G Do Not Write gelOw This )eine <br /> EPA 8700-22 <br /> (Rev.9-88)Previous editions are obsolete. <br /> Yekw: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS <br />