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Jan -10-03 02:00 3 EIWR"CiI ANO AUTO P_02 <br />acme or t.autJrruo—l:nvj!u,m rtioi rrareclion agency <br />Form Approved OMB No. 2050-0039IExpiret 9-30-99j See Instructions an back of page 6. <br />Please print or type. form dirsignad far use on #lila f 12•prtch) rypewriler, s Deportment of Toxic Su6slanc. tWlrof <br />Sacramento. Colifom; <br />i► UNIFORM HAZARDOUS 1' Getseraror`t U3 EPA t0 Na. Monilia [locunent No. 2. Page 1 Information In the shaded or. <br />WASTE MANIFEST CI� 1 L10 10 1 0 , I , 1 19 16 i 7 I 1 . S . 1 6 it nor required by Federal law. <br />4- <br />.14-7119 <br />3 i4799 IN. THORTON RD. <br />L0131, ICA 86291 <br />A. Generator's Phots(809 f 368-9100 ° ' <br />of <br />Sfob'Alanl(eyt paewltent , bM /� <br />5. Transpo�r °r 1 Campany Name 6 US EPA ID Number al'e,'frq ' Wiife lG <br />SHOP ILMMS SOLU'T'IONS C A 0 0 0 0 6 9 6 9 9 7 <br />4, Te�nipoFlw¢h' . es, t$1}0`'`F84^'79lRR' <br />Y. Tr pot' r 2 Compony Nam* $ US EFA ID Num6sr <br />-ki <br />9. DesigngteJ Faci'ry Name and Site Addros' 10, US EPA ID Nyml>er <br />CROSBT t gVERTON <br />1630 17TH ST <br />GONG SEACHr, CA 90813 IC 1A ID 113-2 8 1410 19, <br />I t. U3 DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number} <br />a°ASSORSEW3 WITH OIL z Yl1ESE."L <br />NON-1R.CAA MAZARDOUI WASTE SOLID <br />b. <br />C, <br />F4 <br />tYlsepprte .e l <br />S' �il:�1GR��1fajlrag. �I�� <br />-Mr-y Y auf ; <br />0 13 1 D IM I 10 17 10 10 l' V <br />J" Add1fidngiPq a'apNone fgr,Mar4riall titled Above I <br />�Rt7E'ILFr . $pSl ��� ° <br />14$, Special handling losiruelione and Additional Information <br />APPROPRIATE Fi;OnCTIVE CloCIT tING <br />R12) > NCY CONTACT. (800) '746-74,99r <br />SEE E.R.G. PAGE #171 <br />16, GENERATOR'; CtATRICATION, I hereby declare that this contents of this consignment art lulls and accurately deii:46ad above 6y prgper ship�ing nam and ore elastlfied, packed, <br />mork,ed, and labeled, and are in all resperfl in Pre,per rondiiioa for ironsPan by h;ghwoy according to o hca le international oe�d naliano goverms{eni regulations <br />if 1 am a Targe quantity generWor, f nrtify that I haw o p tom in plots, la reduce the volume and toxicity of waste generated to the degree I hav delermin b be etonomicaBy <br />Prac'ica6le and that I here selected the procl4a6le method of tr#otmeal, storage, or disposal. currently available to me which minimizer the present �nd Future 166al hs human 6eallh <br />and the environment OR if I am a s all r- I h d <br />19. Discrepancy <br />Z F <br />A <br />C <br />L <br />f 20. iii Otin <br />T Prin /Typed Rt <br />i i ate <br />DO NOT WRITE BELOW THIS UNE. <br />Item 19. <br />1, <br />Month Day. Year <br />o I ,stZ in I-� <br />DTSC 8022A (1/991 Whip T50F SENDS THIS COPY tO DTSC WITHIN 30 DAYS. <br />FPA 9700-22 To: P,U Box 3000, 5arrpme o, CA 95612 <br />M quan try gen#rale+, <br />ovatloble to m■ and lfiol I tan afford. <br />ove ma e o good faith effort to mrn{mlxe my was'■ genevation and select the belt w6ste manogamem method that is <br />Prinled/Typed Name <br />Signature - - <br />Year <br />17. Tran I <br />1MonthDay <br />rter Acknawl■ t of Retei 1 of Materials <br />It <br />Prinied/Typ■d No ' — <br />W5, t ;.-I f, <br />Signature A <br />I <br />Month Da /tear <br />y <br />-% <br />f/ <br />a 16. Tran , rtes 2 Acknowledgement of Recei I of Materials <br />/TyNLLI e <br />u Month Day Year <br />1 J�I <br />19. Discrepancy <br />Z F <br />A <br />C <br />L <br />f 20. iii Otin <br />T Prin /Typed Rt <br />i i ate <br />DO NOT WRITE BELOW THIS UNE. <br />Item 19. <br />1, <br />Month Day. Year <br />o I ,stZ in I-� <br />DTSC 8022A (1/991 Whip T50F SENDS THIS COPY tO DTSC WITHIN 30 DAYS. <br />FPA 9700-22 To: P,U Box 3000, 5arrpme o, CA 95612 <br />