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Pbaa print ootype. Posen despned for use on offs ()2 - <br />it I UNtFORM HAZARDOUS <br />WASTE MANIFEST <br />V3 <br />N <br />t\ <br />N <br />0 <br />G <br />U G <br />E <br />—1c N <br />DO E <br />R <br />�v A <br />z T <br />�3 R <br />A <br />N <br />O <br />m <br />m <br />O <br />N <br />Q <br />d <br />m <br />C <br />w <br />z <br />u <br />U <br />a <br />Z <br />O <br />z <br />Z <br />w <br />S <br />a <br />c T <br />O R <br />> A <br />Z N <br />w S <br />U P <br />w O <br />R <br />w T <br />O E <br />w R <br />N <br />U F <br />z A <br />- C <br />L <br />T <br />Y <br />See Instructions on bock of page 6. <br />h mop. <br />�ors (b EPA ID NO. Manfest Uccumel%wilb� 1 2. Page I <br />A14 i9 l7 i115 i2 i0 i8 i3 i41 0 1 01 O l O I 1 Of <br />Toxic Substances Control Program <br />Sacramento, California <br />IrYomrgtion in the startled Xara0f <br />s not required by Federal <br />25600 Christman Road, Tracy, CA. 95376 e, sae eaors <br />GGenwarofs Phone(209 ) $32-952$ f I 1 (. r 11 t s [ t <br />5. Trarnponst l Comport' Name 6. US EPA ID Number C: _State Trassporter$10 <br />H & H Ship Service Company C 17+ I D I O I O , 4 17 17 11 11 IIS 18 D- Tmmpoaehphorfe 1 <br />7. Transporter 2 Compary None &WEPAIDNumber E_S1oleTronspodelelD <br />San Francisco, CA 94107 °Ctl" Pn0 ° <br />C lA ID 10 10 14 17 17 11 11 Ib IS 415 543W 835 <br />12. Container 1& Tota 14 Urvl <br />11. US DOT Description (ncksdksg Proper Shippkq Name, Hazad Class. and ID Number) No. Type Quant' W+Nol 1 Wasfe Nrmber <br />a ISta e <br />RESIDUE LEADED GASOLINE TANK I532 <br />W, <br />RON-RCRA HAZARDOUS WASTE SOLID 0 10 X T IP 0 10 12 Al P P <br />Q <br />JOB 810974 <br />24 Hr: Emergency Contact: H 3 H /(415) 543-4835 <br />APPROPRIATE PROTECTIVE CLOTHING AND RESPIRATOR <br />. GENERATORS CERTIFICATION: 1 tsereby declare that the contents otths consignment are fuly and accumhely tleschbed above by proper shipping name and are ckm(ed, <br />packed, marked and labeled. and are in ON respects in proper condi ion for transport by highway according to applicable International and nglional9ovemmeM regsfariorn <br />K I am a large quartity generator, I certify that I have a program In place to reduce the volume and toxicity of waste generated to the degree I irne detemnned to be <br />economicaKy practicable and that I have selected the practicable method of treatment, storage. or disposal currently available to me which minkn¢es the present and lutea <br />(teat to hamart health and the environment; OR, K I am a small quantity generator. I have mode a good faith effort to mirem¢e my waste generation and select the best waste <br />mo ogemast method that a available to me and that 1 can afford <br />nt Ygea Name, signature , ; r naonm Day year <br />C�/�',) /f 017 11 14 19 12 <br />JAs R- MCFrM rr� i'. 71 <br />Discrepancy <br />NOT WRITE BELOW THIS <br />017 11 14 19 12 <br />DK8027A(12/90) E -F 1c1,OSLj,r,r--- Yellow: TSDF SENDS THIS COPY TO GENERATOR WITMN 30 DAYS, <br />EPA 8700-22 <br />