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-rarmavpproveo vmn rvo.ZVaV -I Sacramento,�anrm+a <br /> ''lease print or type. Form designed lar use on elite(12 pirchr writer. r <br /> �+ * Generator's US EPA ID No. Manifest Document 1•'- 2, Page I Information in the shaded ares <br /> �'' UNIFORM HAZARDI>US ; is not required by Federal lar <br /> WASTE MANIFEST A D 9 $ 2 5 0 8 7 S 1 4 6 7Y °f <br /> A $fate Manifest Document Number <br /> ` 3. Generator's No and Mailing t+ddressi4 - s y . <br /> Unifiedt o �S - Attn: Pat Gui.l.l.e-met <br /> 52t)o Sheila Street, flo�T>��wce, t A. 90040 B Scute Generator i ID" <br /> 1 <br /> LO 4.'Generator's Phonf 323 264-5200e � - <br /> 5.'Transporter 1 Company Name -6. US EPA ID Number C State Transportet's ID-[Received] `'-€8� <br /> co <br /> D Tmnsporte>s Pfi'one =.' t <br /> O Hoz Nett Tri�r►s, 1 nc• CAT © 3 t3 0 1 2 9 fJ 0 . <br /> O <br /> as S. US EPA ID Number ,E State Transporters 1D.{Resr;'rved] =r�r ,� ar r£T h „ <br /> 7,kTransporter 2 Company Name <br /> 10. US EPA IA Number G'§Statg Faci ttyrs fLt �t 3 } M " " <br /> V Name and Site Address s y ps <br /> �/� 9.`.DesignatedpFa[lillily�;..,�,y .. <br /> Li fQCron�'>ZT 6f V VGL i..Qn' ,L`„ <br /> 'moi <br /> FiicE�f <br /> 1.630 t�,'.17th- <br /> _ � � e <br /> Us�o CA .1 9ny81°3. ki D 0 �. 3 <br /> e '�.r •`;u .{�=YE' .,.a� ;ri.ab rgr,'D �.. ]2:'Coista.iner's' ; lA:":Unit <br /> US DOT°Description f indadri g Proper Sh10 <br /> ipping Name,9 Lazard Class':an tD <br /> Number No: T P@. VE <br /> t 'puannly Wt/Vnl, t std xds t <br /> a. <br /> ('tri.bssC?r t/diesel/ai.l) <br /> D P EPl�lf3itsgr <br /> 6 c � <br /> 3 �ON-R RA. <br /> dM <br /> m E CrE AE ` Sa Fr1fA? E, 2.1., Ut19S0r n M P 'EpaYr1+ : 4 `� <br /> -4R <br /> c O WAS`T'E a)MOS1� ,tMID.* N.O.S., 3, IF',i175�1, P.G. II P �fx'; 21�, <br /> •r <br /> LU d Stater a . <br /> Z gM TfLp IfJJI�r�' 9Ca�i3`I'IO\T, 3, TJN1791 , P.G. IT <br /> l PA/Other <br /> ru - - j - <br /> N l Addttional desi:44on's,for Materials Listed Above K Man, mg es far Wastes Lrsted Afivve , s� t x <br /> Z tt/d esel/cal - Pr dfil& #51.1'93 <br /> .) a arosals - Pk0file #51192 LUF <br /> d y` <br /> Z 15. Special Handling Instructions and Additional Information// M „ <br /> 0 , tl3 ! `�" Job Site: Stoc�ktc n Facility . <br /> a .�5 rC �� 199€1 Pi.codii Rd. <br /> Z t � <br /> U Jow 5 �. #909149-5607 Stockton, dA.. 95215 <br /> r <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this conalgnment are Fully❑nd acw�ateI,described above by per shipring name and are classified,packed, <br /> Vmarked,and labeled,and are in all respects in proper condition for transport . highway according to applicable international and nation government regulations. <br /> —J+ If I am o large quantity generator,I certify.that I have d� <br /> a program in place to reduce the volume and toxicity of waste generated to the p„—Lave-,determined to be economically <br /> a practicable and that I hove selected the prgctfeable method of treatment,storoge,or disposal currently available to me which minimizes the present and future threat to human health <br /> in and the environment;OR,if I am a small quamtity generator,I have made a good Faith effort to minimize my waste generation and select the best waste management method 6431 is <br /> ac . available to me and that I can afford. <br /> OPri d/ ed Name f Signet' Month Day Year_ <br /> z O l <br /> i 17. Trans rter 1 Acknowledgement of Receipt of Materials <br /> R Si nate Month <br /> wLU PrintedJTyped N e fJ Day Year <br /> S Aeg, / <br /> rL 018. Transporter 2 Acknowledgement of Receipt of Materials <br /> I 0 T Printed/Typed Name Sinature Month Day Year <br /> V 19. Discrepancy Indication Space <br /> pF' F <br /> Z A <br /> C Y <br /> L <br /> I <br /> 20. f-aciliity Owner dr Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. .. <br /> T Printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A (1/99) <br /> Blue: GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> EPA 87700-22 <br /> To: P.O. Box 400, Sacramento, CA 95812-0400 <br />