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<br />I . Gan - tor;) US: EPA ID No.
<br />U1NI.FORI4l 1HA IRD.Ot1'$ q
<br />Manifest Document No, z- Page 1
<br />Sacramento,Colifornia
<br />1nFermation in the shaded areas
<br />WAST I MANIFEST A L 0 0 0 1 56 7 7 fS 2
<br />is not required b Federal law,
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<br />3. Genn?dtoe. Ncme and.Mailing Addreu
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<br />N 18, Tran oder 2 Acknowled ement of Reeei f of Mateels
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<br />SHOP I3A.LA121:15 SOLUTIO -KS C A 0 0 11 0 h
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<br />9 Designated Facility Name and SLft Address 10, US EPA ID Number
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<br />Special Handling Inetruclions and Additional Infermofion
<br />APnLa�leZ.OPRIArxPX+: PROrECTTVE CLOMITK3
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<br />cONTACT; (800 746—'j'449"
<br />SM F. R. G. PAGL'
<br />16, GENERATOR'$ CERTIFICATION: I hereby declare that the content, of this consi nmehl are fullyand I described above b proper ship in name and are classified,
<br />marked, and labeled, and ere in all respects in accurately y p pe pp g I packed,
<br />pe proper condition for transport y highway according b app iwble international and nary'On0 govarnmonf rogulalians,
<br />p I :" o Jorge quonrity generator, I certify that I have o program in place to reduce the volume and toxicity of waste generated to the degree I have determined to bo economical)
<br />pro he .le and that I hwo selected the romica6le method of treotment, .tor e, or yy
<br />grid the enyironmant OR 'f 1 P a9 disposal currently available to me which minimizes the present and future thryat to human hoolth
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<br />r am a 6100 quantity generator, I hove made a good faith effort! mi im tz"y�yaste
<br />available to me and that I con afford. o
<br />' r^� �`
<br />generation awaste
<br />rood select the best management method Thal is
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<br />MOnffl Day Year
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<br />N 18, Tran oder 2 Acknowled ement of Reeei f of Mateels
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<br />DT5C 8022A (1/99)
<br />EPA 81Dp-22 1
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<br />ous mgterrats covCreo bY this manitest QXC9pj as noted in Itom 19,
<br />Signature Month Day Year
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<br />DO NOT WRITE BELOW THIS UNE.
<br />Yellow. I'SDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS.
<br />(Gcnorolors who su6mit hazardous wasle for fronsporl oul'-of•slote,
<br />produce Con,pleted'capy of this copy and send to DTSC within 30 days,)
<br />YVA Lfi:00 9TOZ/6T/b0
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