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<br /> State of California Environ nenfal Protection Agenry Sed II15tfUCtlOilS Ofl �I01 Of Ir'` Departmen!of Tozu Substances Control k
<br /> .Form Approved OMB No.$45",039(Expires 9-30 991 - - E _ -- _ :,{ - Sacramento,California - y
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<br /> 1: �ienerator s US EPA 1D No Manifest Document No. 2:.Page-1 Information m the'shaded areas
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<br /> WASTE MANIFEST C 8-D '.n
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<br /> Z ' 15. Special Handling Instructions and Additional Information
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<br /> : 16.:GENERATOR'S CERTIFICATION: I hereby declare that the contents of thircansi nment are'fully.orid accurafaly described above by proper ship mg name and.are classified,packed�' }°+_,• ' a3.
<br /> V. marked,and labeled,and'ore in all respects m propercondriioi for transport by highway according to applicable mfernat_ional and nationaPgovemment regulations y
<br /> If f'am alar a uariti generator,'I certify that I have`a pro ram m place fo-reduce the valvme and toxicity of wasietgenerated to the'degree I fiave determined to be ecanomicall';'. i
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<br />' procticoble and that I have selected the practicable method of lreatnsent,storage,or disposal currenllyavailable to me which minimaes rhe present and future threat to human health "-
<br /> `n and the environment;OR if I:am'a small quantity generator I have made a good Faith-effort to minimize my wade generation and select the best waste managamenf method that rs ', i
<br /> 11 available to me and that f con afford
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<br /> P.rinled/Typed Na - Sin„aryl's -" =.� �•. f Month DayYea
<br /> W T 17. Transporter 1 Acknowled ement of Receipt of Moienals F
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<br /> 0 p is.. Trans rter.2 Ackriowled ement of Receipt of MaterialsZ.
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<br /> V 19.Discrepancy Indication Space.
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<br /> L' 2Q Facility Owner O orator Certification of recei f of hazardous materials covered b' this manifest except osnoted in Item 19 `
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<br /> p0 NOT,WRITE BELOW THIS 'LINA '
<br /> DTSC 8022A(1/991 _ i - Yellow GENERATOR RETAINS
<br /> EPA 8701-22
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