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• raY..rr—fixronrweant.,,ofr!•pOehl hpewrifer. r u .. u —,+vasno...s.onum <br /> Sacramento,California <br /> UNIFORM HAZARDOUS1 r, mkt s US EPA ID Na. Moni6l Document Nc 2. Page I Information in the shaded areas <br /> C <br /> WASTE MANIFEST `✓C I O2 \J li rwt required by Federal law. <br /> a " � � ^ of <br /> 3. GemraM•s Name and Mailing ,ess nifest reent te <br /> VAN SHALJEAN Wr <br /> h 4255 RIVIERA DR., STOCKTON, Ch 35244 � at b1i � <br /> nd. Generalor's Phone 1209 1 464-04-}5 <br /> hS. Transporter 1 Company Nome 6. US EPA ID Number S4ae T' R— <br /> CP m ,r <br /> o <br /> 7. TnmpoMr 2 Compony Name S. US EPA ID Number 9osegT Re - `if <br /> J �>18!1 <br /> yµ <br /> �Q �' Ttsins a 4 ,a(Sig s ..c, >aTN�+,^Xf�e,Ptiy^ r •:.p <br />�V 9. Designated Facility Nome and Site Address 10. US EPA ID Number ,Slate Facdt i xB� r <br /> 7a AMERICLEAH. INC. rY <br /> Z k . <br /> 7� 2570 ALMOND DR. <br />*� all <br /> :F .S=. 11"r IRC-4261 IN I MD 191812 131E 14 3 <br />�}� U 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Conlainen 13. Total ld. Unit '7 = <br /> r) No. 1 Type Ouanlity Wt/Vol '..i' <br /> Z a. <br />�= NON-RCRA HAZARDOUS WASTE LIQUID _ <br /> g (WATER G SLUDGE) ^ MON_ P <br /> n E b. µ`r!.e4., <br /> ora N <br /> m <br /> E. <br /> e R 9= MI <br /> v A s.r <br /> 6 T C. <br /> a�0 O <br /> R <br /> Z <br /> w <br /> V <br /> Z Desarplrns �#1°br'g1F rq^ +(, Fhndligg'Cod' u: dsM stet' "` <br /> Q <br /> LAIt <br /> �... <br /> wv� <br /> 0 IS. Special Handling Instructions and Additional Information <br /> i APPROPRIATE PROTECTIVE CLOTHING STfE ADDRESS: <br /> w 'EMERGENCY CONTACTS (209) 541-9145* 334 N. AMERICAN <br /> STOCKTON. CA <br /> 16. GENERATOR'S CERTIFICATION: I herby declare that the contents of this consignment are fully and accurately described above by proper shipping name and ore'classified,pocked, <br /> Umarked,and labeled,and ore in all aspects in proper condition for transport by highway according to applicable international and notionol government regulations. <br /> If I am o large quantity generator,I certify that I have a p ogrom in place to reduce the volume and toxicity of wotte generated to the degree I have determined to be economicollYY <br /> ydj practicable and that I have selected the Procticable method of treolment,sloroge,or disposal currently available to me which minimizes the present and future-threat to human heohh <br /> ,d tF. eni:+ns•*; t i,I c. - uu yum.liiy g...,x i have mode o good tests,."ort'is minimize my waste generation and select the best wash management method that is <br /> O available to me and that I can afford. <br /> > Prmmd/Typed Namt" SignoNn �— ; Mond, Day Year <br /> W T <br /> (� R 17. Trans iter Acknowled emenl o ecei t o Materials - ,,. <br /> A Printed/Typed No SignoNre / Month Day Year <br /> — - e r - <br /> _ � <br /> P <br /> st- 0 10. Trans rte,2 Acknowled ement of Recei of Mater'mis f / IF <br /> O R Printed/T Nome <br /> ILA [ YP^d SignoNn` Month Day Year <br /> Q A <br /> V 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> I <br /> L <br /> I L 20. fac.1tV.Dreir or Operator Certification of receipt of hazardous materials covered by this manifest exce t as in Item 19. <br /> T Prin m SignaNr �, - - Monti Day Year <br /> - 2 7 <br /> DO NOT WRITE RdbW THIS U E. <br /> r. <br /> DISC 0022A(1/99) r <br /> EPA 0700-22 �_ Green: TRANSPORTER RETAINS <br /> e _� <br />