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State of Colitornia--tnvrronmentar rroiectron,vgency W SeiD"IMtruCtions onbaCKoTr"Qv u•
<br /> Form Approved,OM8 No.2050-0039(Expires 9.30-99) .f'. t $atramenlo,California.
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<br /> enerator's US'EPA ID No _ - Manifest Document - -g '� {s nni required'by Federal Icw
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<br /> A 15. S fiaIH andlin Instructions and Additional Informolion
<br /> ° E R PRUUTNE CLOTHING = E11'7ERGENCY RESPONSE:
<br /> z utit ,`� San"Joaquin Filter Rec3 clutg (S59)498�0244
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<br /> . y 16. GENERATOR'S CERTIFICATION: I hereby declare Thal the contents of this consignment are fully and accurately described above by proper shipping name and are classified packed
<br /> U - marked,and labeled,and are in all respects in.proper condition for transport:hy'h'ighway according to applicable international and national government regulahans:
<br /> J t L have-a rogram in lace to'reduce the volume and toxicity of waste generated to the degree`I'have ter
<br /> ::j econoinicall
<br /> � - If I am a large quanti generator,;I certify the p P y
<br /> of treatment storage,or disposal current) available to me which minimises the present and future',threat ta-h'oman health
<br /> y 6le method Y
<br /> t practicable and that I have selected the practice g A
<br /> 4 i u and the environment;OR,if I-am a small quantity generator,I hova-made a good faith effort to minimize my waste generation and select the best waste-inanagament s4_eihvd that is
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<br /> f available to me and that I can rd:.
<br /> } Printed/Type Name - Signature .., -Month 'DayYedr
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<br /> f Materials
<br /> f T 17. Tr ns oder 1 Acknowled emani of Receipto '”
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<br /> ! - A Printed/Typed NameLU
<br /> Signaf�ufy ter,
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<br /> _O 0 1 B. Trans o er Acknowled ement of Receipt of Materials
<br /> Printed/Ty p d Name Si nature ' - -
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<br /> ' U .19. Discrepancy Indication Space ' _ �'• - k `. - .. _
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<br /> 20 -Facility Owner or Operator Certification of'recei t of hazardous materials covered.b this-manife e t ed i 19..
<br /> T P / YPed Name - Signature I _ Month Days -:Year
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<br /> 'DO' NOT- WRITE.BELOW,THIS LINE.
<br /> ( Yellow:` TSDF SENDS THIS DOPY TO GENERATOR WITHIN 30 DAYS. ”
<br /> `I {Generators.who submit hozordaus'waste for tronsporf out-of-state, -
<br /> I DTSC 8022A(1/99) produce campleted copy of this copy and sent to DTSC within 30.days-j
<br /> —22
<br /> EPA 8700
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