|
SlateotCalitomia=tttvfronmenV0Lrratecnanngency,.-',: � _- See Instructions on DQGIc us£T -
<br /> Form Approved DMB No.2030-0039[Expires 9-30-99y r r Sacramento,California
<br /> Piea'se print or_ty�. Form desrg_ned for use on elife'(f 2-prkh)F'�meter m: Manifesl1Documenf N 2. Page 1 Information in the shod
<br /> areas,
<br /> : ierator s US EPA ID No - - is na6requrred by.Fedar, law_
<br /> UNIFORM.HAZARDOUS_ " of
<br /> i VyASiE.MANIFEST ' 0
<br /> - -r- .s �. '��_a ,-7 a.,e•i ter'`,
<br /> 'Ae 5ta19 MamfesF'Z)oeument Ntiminer
<br /> 3:_Genet tori Name and Mailing Address
<br /> 1 I�1 w!u' Y2 rC !«3
<br /> _B SEale�GehaCalor -
<br /> - �.•'✓-dr ys�f s'�x r~-..�"F ''7�`'t �� � ^'e v;�-,y.
<br /> p --.iy - - - _ .. t' 354v# 4`'` x4 �w- •Nr S � $ m,s- ° ,
<br /> in 4.'-:Generator's Pho;e!1,51t3.1: 7_404` [�
<br /> 6 US EPA ID Number- tC Slate Transporter s ED{Reserved j � 1 q y
<br /> cV 5 Tranpo�ter 1 CoQ�q�r Ntype c, Yr^ -
<br /> in �9a13�i►9r1'4�tT$i!!°R[LL"ty#SC�LI�iEl! ' " D r s 'h '��r
<br /> ( 39980240_. {
<br /> �.. °#' .�sa rt Y /.t
<br /> -- en's
<br /> O _ 8 US EPA ID Number, E FState Tronapdrfer�s ID[Reserved Ii s x
<br /> rb ' porter.2_7:TronsCompany Nome 5 r -
<br /> .
<br /> Q 10. US EPA ID Number G xStote Fatddy s-IDS „r� s+ k' L °`
<br /> r
<br /> r
<br /> V Designated l Name and S
<br /> de Address nit m,
<br /> -.9. D tY _ -.. ,• - ,•srr ,�, s;;7's ;,�'�,.: :,t.=+'s�'rt"�q;�.
<br /> r�
<br /> 9
<br /> r � M.ilU7ll.A■�- - :rYk,rl!' >'±i= 3•"zl--.S I':''-4�='
<br /> �,�$ .E. -
<br /> .:
<br /> O '93648
<br /> W - rw- 12 .Contameri`- 13..7otai• ,• ld Unit
<br /> Nowa, OOanti Wt/Val' cl�asle,Numloer r �
<br /> 1.'US DOT Description{including ProperShipping Name,Flazard Class and ID NumFier) _ _
<br /> No T pe tY
<br /> �d AN cv t;;�ar�r�it���J�eii��� �
<br /> iv
<br /> State ^
<br /> E - sc
<br /> m6 fPA/Offie
<br /> 0 E s ey ?aA s
<br /> C, A; toC.
<br /> SO
<br /> d.
<br /> LLI
<br /> 'Q r11 ,,•�q��q}}
<br /> W y,
<br /> k p d3 y:H h i> K Ha+bhngCod'es,farrtiVcsfs tisled AlObve f } '� " y
<br /> - ofenol's':Li'sled Above`; ,r fx'-ne. :fid 'h".r�,d`.;•5:.=" ,# Aly �.9- i 7'N•'r .'S+',�r9' # A w:,.,,,�.. .' ,�r 4+ ;.- :. '.,z. aa,,n�`„.';.,•F-4
<br /> '�
<br /> •P �, gw,• s:�d �' � k�' 'si,?g .'':7"� t.Pf n.i3t1. � �,� r'�.. �`.r'^� a" �..�;`1',+%,a a �,.'...�'' - c- 'y
<br /> -r?:' •;r„ 1<^ t� �✓: :�a ,�.
<br /> aT5
<br /> .,• _ :0y : .;� ' 02x
<br /> P -P`
<br /> W '.t ,u;.-r`w;s�'t '- .e✓ � -,��+,W�'' s;`' . r .�" k k'F 'Fi-i ,o.' t �.�'yi�' L,r "''�,:2--r� _r,�_. C:"`r.-,'f Kp' "rx,?rk•�+ x '� aF. ,.kh:rt�;'v z -"^`w '' rr`,�`;aY•,�s-',
<br /> ."'1� -�i-VY•r}:�'s ?�,'!'� ' s'F'+ ! r t7�.-a ' r:r ''t'-���'- '+ ,' �* '�- 's' ,�,
<br /> Qlu.. -r-�.LS 15._7 a�`+e- _•'� .7*e K'�,, 'sq 'rw'-.G-, r ,�1+r,;r L,_ -�r", d ,. :'. •9' "xr'�{t-:,�-€'r�, 2;-?,,,',p '- '' r"gZ;, y-''�.� •s;�s '" �
<br /> J 5y' fix ' -E1 ,{ r 4i - e+ ? P -
<br /> ! °' ., a .. x>r''€�'y,t'Y 1`fEr'1:y �'ic�:s:;r°.4- 'nom*h�.s:�1Yv:�,.���ti�a'"2nd'°�..rR">�sr�:f •'Y a.�''�i^�7`'r''S� _. .� ,a-.1+ � ;.r, -
<br /> # Z '- y15 5hpe j=ot}f ndyl�i;na57�Inst(ructi nsLa+n�d Add�rrtiron�al Information - ' MERGEN sY R SPi�4,y-Lr'C;
<br /> _- O1'r1Li !� �..r ,R.\� l-�AV'.7�:r •,-
<br /> - � a
<br /> a = dl1 I- c ��.�7 r � M�� txi 3oagan FtR4'1=ft% (559) $-020
<br /> LU
<br /> GENERATOR'S CERTIFICATION: I hereby declare that the contents oflh3scor siggnment tire hwa falccordih and accurately descria61r iniernafioriold above yand noiioner rol-governnment regulai onsfied packed
<br /> V �'_marked,and labeled,and'are in all respects in proper condition for lransportby h:g y - g PP1i
<br /> to-the de reel'have:determined to be economical)
<br /> - to.reduce the volume and toxicity of waste generated g. _ y
<br /> t t l have a pre ram in lata health -
<br /> IF I,am a la�ge`quonti generator,I certify tho p g p -
<br /> Practicable method o}treatment,storoge,or disposal currently available to.mawhich.minimizes the present and Future threat-to Kumon
<br /> ry ve selected the ria ement,me
<br /> thud that'is
<br /> s,.;:, d° -practicable and that I ha
<br /> _ and the environment;OR,if I am a small. uonti enerator,I have mode o ood Faith'effort to minimize niy,wosie'generation ac d select the:be'st waste mo.'n,
<br /> 1arailoble l0 4e and tha')can' rd.
<br /> 1 Signature Month Day' Yeor
<br /> y Printed/type ome f
<br /> -.Z �
<br /> W '.T a 7. 7r ns otter 1:Ackhowled ement of Recei 4 of Materials' - - 'iw - '
<br /> ='e'{ -' _ - Month' Doy Year
<br /> 1 Lr.r .Printed/Typed No. J..._ ., Srg;;°IuF Fr,r ':,,,,,,...w� ' 1 ,.C,� '�.
<br /> _ _
<br /> LL. p 4'18. Trans otter 2 Acknowledgement of.Recei f,oF Materials nth pay'" Year
<br /> i.,... 0 Si nature .. -
<br /> Printed T Name' - - ,-
<br /> •T
<br /> Y
<br /> w d _
<br /> E
<br /> R
<br /> („) '19.'Discrepancy Indication Space - - -' -• p -J`- i i.i} 'Cj ' •j.
<br /> .p' F z
<br /> L
<br /> .l 20. Facility Owner'or Operator Certification of recei t of hazardous materials covered b this manif e t noted in Item l9. '
<br /> Signature - - - Month- Day Year
<br /> .T ?Printed/Typed Name' - _ i��`..�,,;�,�„•,-•,� -
<br /> :Y
<br /> QO NOT WRITE;BELOW TH15.LINE:
<br /> DTSC 8022A 11/991 Yellow: GENERATOR RETAINS
<br /> EPA 9700-22
<br /> i �_�.�.�.`.r..r.rsr...�r...r. _.._�,�..r....�-��-.._�.�,a.�. , h�..�. ._.r.r+•_..f.:'�'"'_""-�"'�'_"..w.�..-.....r3 _' ....._M � ._.�-r��.:._�.._...�r-,_.,��, ..
<br />
|