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- p rlmenf of Toxic Substances Control <br /> State of California—Environmental Protection Agency See Instruttions on back of pa Sacramento,California <br /> Form Approved OMB No.2050 0039(Expires 9.30.941 <br /> Plan prirr-or typo. orm designed for use on elite(12 2-pitch)ryftqWManifest Document No: 2. Page 1 Information in the shaded areas <br /> 1. t_.,erator's US EPA ID No. is not required by Federal law. <br /> 'UNIFORM HAZARDOUS <br /> WASTE MANIFEST CAD 9 $ 25 0 8 2 5 1 6 0 Q` r3 of <br /> � <br /> 3. Generator's Name and Mailing Address - ,- Atka:Piat GUII - <br /> ' s e - <br /> � <br /> OUnillied ASt8fT1 GiQCeIS <br /> 5200 & 4C3 <br /> ,����S+tre6t <br /> OMnA 90f <br /> t� 6. US EPA ID Number. riaTTttspo �s ti ° � `' t <br /> tit 5. Transporter 1 Company Nome r •_ <br /> ;pi–Im W9 <br /> � 8. US <br /> 7- Transporter 2 Company Name <br /> J <br /> V 10. US EPA ID Number <br /> 9- Designated Facility Name and Site Address <br /> a DYK Environmental <br /> .0 3650 E. 26th Street <br /> 0 - <br /> J 12.ICA <br /> Containers 13. Total <br /> I. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No. Type Quontity Wt/Vol �,, a• _ <br /> ir <br /> X Non-RCRA, Hazardous Waste Solid - <br /> E b. <br /> m E <br /> C44 A ` <br /> C. <br /> 0 <br /> w d. w. <br /> Z <br /> c <br /> I su <br /> v r'•-_ <br /> Is.i - <br /> � <br /> Q <br /> Lu <br /> ' - •a - rrH '� iii'` k- -' •,� - <br /> I- � �'� ,, •ti:.�-��' `:s �,�, ,;h_•,_-� ?9i7Y�3sr�. �%� .:.,rkY ��J��.:t� '�,'��,�3,.�;� ;�i3 f'.. ��r,a��` r� '::�r � � � ��:A .Y�.. _:;r�. <br /> 15. Special Handling lnitructions and Additional Information //11 <br /> 0 Gloves Gaggles f6� JOIE Site: 1990 -Piccali Rd. <br /> Z Stockton, CA. 95215 <br /> _. I�vag. #909-B89--5607 <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and-accurately described above by proper shipping name and are classified;packed, <br /> Umarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations.. <br /> J <br /> if 1.am a large quantity generator,I certify.that I have a program in place to reduce the volume and toxicity of waste generbted to the'degree I have determined to lie economically <br /> d practicable andahat 1 have selected the ppracticable melhod-of treatment;storage,or disposal currently available to me which minimizes the present and future <br /> .ilirent to Kaman health' <br /> N and the.environment;OR,if I am a small quontity 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. <br /> Signofure <br /> Z Month Day Year,' <br /> >_ PrintadfTy ed-Name /J <br /> A Z1 e5 <br /> Z <br /> T 1 y. Trons ortec_1 Acknowledgement of Receipt ol"Materials - <br /> (9 R - Monlh Day Year _ <br /> w <br /> AL Na a Signature . <br /> tlZ 1571 <br /> Set <br /> 1 ss ZAK 4" <br /> p 18. tans iter 2 Acknowled ement at Remipt of Materials <br /> Month - Day Year <br /> 0 T Printed/Typed Name S' ature <br /> itLu <br /> R <br /> U19. Discrepancy Indication Space 3 t f Z) <br /> V. <br /> — A <br /> Fac' CAv or arOperator Certiricati of rikeipt of hazardous materials cove d', t rigest excc as noted in em 19 <br /> TPii, "` F':.yped ma �' - Signa re' ntfi ay r <br /> 01 <br /> DO NOT WRITE BELOW THIS,LINE. <br />{ <br /> DISC 8022A 11/99) White: TSDF SENDS THIS COPY-TO DTSC WITHIN 30,DAYS. <br /> I <br /> EPA 8700-22To: P.O. boa 3000,Sacramento, CA ' 95012 <br />