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y Form Approved OMB No.2050-0039(Expires-9-3(t991 t Sacramento,Colitorma
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<br /> Generators US EPA ID No Manifest Document''" 2, Page 1 Information in the shaded arw.
<br /> UNIFORM.HAZARDOUS �' :. • = isnot rega�red 6y Federal law.
<br /> j WASTE MANIFEST'. ' ' ` :of
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<br /> I Handlin Instructions and Additional Inforritation.
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<br /> 16 GENERATOR'S CERTIFfCATION: I hereby declare that the coolants of this consignment ore fully and accuratelydescribed above by proper shipping name and'dre classified,packed,
<br /> al and notional overnment re ulatians. .
<br /> w according to a licable internation
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<br /> ndition for trans ort 6 'hi h a seep g 9.
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<br /> � If I store large quontiy generator,I certify that t hove a proggram in ploceYto reduce the volume and toxicity of waste generated ro'the degree.)have determined o be ec yy
<br /> practicable and that.)have selected the practicable method of treatment,storage;or disposal currently avdslabfe to me which minimizes the.present and future threat to human health
<br /> and the environment;OR;.iF I and a small girarntity generator,I have.made a good faith.effgrt fo'mini.mize,.my waste generation and select the best waste management nathod that is
<br /> available tome and that I can afford.,'. _ ” %' '
<br /> I• O PS jWed{�yp,3d'Ndme j Sognatu f ' - Month' Day .Year
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<br /> w ,A -17. Trans rter 1 Acknowledgement of Recei t f Materials
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<br /> w. .0 18. Trans orter 2 Acknowledgement of Receipt o{.Materiols `-
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<br /> f 2p, .FaciIii Owner or'O'erator Certification of receipt of hazardous materials covered b this ma ' si t as nate em 19.
<br /> ,Pri ypea Name.. - Sign - - ,Month -Day Year
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<br /> -. DO NOT WRITE BELOW THIS LINE.
<br /> Yellow;, TSDf SENDS THIS COPY TO GENERATOR.WITHIN 30 DAYS.
<br /> DTSC 8022A(1/991 .(Generators who submit hazardous waste for transport out-of-state,
<br /> roduce completed copy of this copy and send to DTSC within 30_days.]
<br /> li EPA'8 P 700-22 � � � � � � '
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