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'* [ - pe arfinen!of Toxic Subskances Conkrol
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<br /> Form• y._ – 39(Expires 9-30 99r l
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<br /> Mansfest Document No. .'2 Page 1.,, InFormakion'in the shaded areas
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<br /> UNIFORM HAZARDOUS s �J >� of 1 }
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<br /> WASTE MANIFEST *! ty
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<br /> Z 15, Special Handling Instructions and Additional information
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<br /> Scsrk_ton,- CA515
<br /> I and accurately described,above by proper ship Ing name and are classified cked
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<br /> [this const nmenta
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<br /> � declare that - ns.:
<br /> hereby 'aloha
<br /> CERTIFICATION:- nt re
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<br /> "W l b. GENERATOR'S: Bled, Y y
<br /> Q marked;and labeled and are in ail respects in proper condition for transport by highway according fo'applicable mternallonpl and notions ga e e f
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<br /> nti enerakar,I cern that I have a pr�"gra i+in place ka reduce tha.Yolume ano
<br /> nd toxicity oF�yroste g9neraied to the degree resent anhave d Fufarankh eaed t toer an hea{Ihr y
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<br /> IF-I a.a large'qua fi}yy g {T - -- •. -_
<br /> p -predicable and that I'haJe selected'ihe practicable-mei}od SF treatment,stO�agey ur'dispasal currenTly available,to,r 'wl7ich'miniYnizes the p �-
<br /> _ and the environment*OR,if I'.am'a smgll'quantity genaratai',I'have"made a'goo_d:Faith effort to minimize my waste'gene7dkion and seledahe b'esk waste mane_gement niod that rs
<br /> i available to me and than I can afford
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<br /> u'I R "17. Trans iter 1 Acknowled ement of Recei t of Materials
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<br /> owled ement of Recai t of Materials Month -Day Year.
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<br /> Facility Owner or O orator Certification of recei t of hazardous materials covered bl this manifest as noted-in 19 Da Year
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<br /> T Printed/_Typed Nama=.., Signature ,
<br /> - DO NOT WRITE BELOW THIS LINIr
<br /> DTSC 8022A I1/991 _ Yellow: GENERATOR RETAI3N5
<br /> EPA 8700-22 ,
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