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State of California—Environmental Protection Agency
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<br /> form Approved OMfs No.2050-0039(Expires 9-30-99) : 2 ppge 1 lnfarmpdoh in the shaded sweat
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<br /> T orator s US,EPA ID No isnot regaired fay Federal�aW `
<br /> UNIFORM HAZARDOUS
<br /> WASTE MANIFEST
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<br /> 3. Gen orals Name and Meiling Address - - t�ms i'
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<br /> 16. GENE >:ERTIPICATION: I'li fe by ctscinrarohaer cond tioe fd fttansport.by highway.alcco ding to applicable 1ihternational.6nd oti nal goveement eg Iatronslfied packed
<br /> " Q marked and labeled,and are in a p P. P }
<br /> ii generator,1 certify,that I have o.pro ram in to reduce the volume and'toxic!h ble fo me f waste which to nim es nerated to ithe�he p esen and Future)have rthinedreoQ,o human health
<br /> - If I am�a large quart ty B g - -
<br /> a- - R practicable and that I hove selected the epradicable method of treatment stomge,.or dispcsol currently avado
<br /> and the environment;OR,
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<br /> I am a.smalE,gaantity generator,I have made a good faith effort to minimize my waste generation and ieiect the best waste managemen!-method that is
<br /> �' nvaifable to me and that l con afford.' Year
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<br /> 2Dfacili C>wner or O orator Certification af'ecei t of hazardous materials covered b this mon ce t as noted -19 µonth� Day
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<br /> NOt WRITE BELOW THIS 'LINE.
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<br /> Yellow TSDF:SENDS THIS'COPY TO'GfNERATOR W17111N 30-DAYS
<br /> (Generators who submit hazardous waste for transport;ouf of stats,.
<br /> ` DT$C f3022A{1/99 t" produce completed copy of this copy and send to DTSG wdhrn 30 days.)
<br /> EPA 8700-22 .
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