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;tete of calirarna--Ewismemtentol Prokcfi-Agency See Instructions on bock of a 6. rmnr of Tp=ic Sabsmace,Cant'
<br /> 'erns Approved OMR He.2050-0039 USpira 9-300.991 Depeb
<br /> deme print a tYPe. Form des,gned For vse m afTa(12-pildF h - SocramoMo,California
<br /> 1. Geam,skls US EPA 10 No. Manifest Doc°men,tJo. 2. Page 1 InFormoice in the shaded areas
<br /> JNIFORM HAZARDOUS is no required by Fedeml Mw
<br /> WASTE MANIFEST CAT 0 8 0 0 2 115131818 12 10 1
<br /> 3. 0eaerater,Name and Mailing Address A °'° °a` '�mn"it Numfms;
<br /> PACIFIC M-1 -- �, 5 5 3
<br /> > 10 BZ r, %r ROM # B. Slote Go-nem9w',ID -µ
<br /> A. Geaerato,'s Phone.8M PMM CA 94583 (925)823-8866
<br /> �y 5. Tran kr 1 Com a�n Name6. US EPA ID Number C.
<br /> �oN & $tate Trp,nporter'a IO[Ra>_erred M 48 _--_—
<br /> yY'! tl T,ansya,+ers Pl,w
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<br /> 7 Trodspedar 7 Company Name 8. US EPA ID Number E, state Transpoder's ID IRe,a
<br /> r F Trauposs.',;Phone
<br /> FacdAj yme ad Si,e Address 10. US EPA ID Number O. Stoc Faolsly's IU' �-'—
<br /> SVUvromtal Technologies H —L vj—LJ—LLL -Ll.:l—L_—
<br /> ,4. Road
<br /> Q�as�,.,han linduding Proper Shipping Nam,1-ks ad'lass,and 10 Number) N Con,mn y I3. .IT.a' I3. V.l
<br /> ;yv-T��r. Na Type Quantity � -Wt/Vol 1 Wgzre Number .
<br /> 1AA88L9 LIQUIDS, 11.0.S.(=LI88, DIESEL), 3081993 PGII
<br /> $61128)
<br /> 0 '0TIT 1113 1116
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<br /> ,hu<liaa,and Additional lnformalion -j ,T v- i�s�y Z�JS \ '10
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<br /> 8SSP08S8 CUL (800) 941-1701 Y
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<br /> -'S CERTUICATIM I hereby declare That the catentr of this cansipmn 1 are fully and accum described above by proper shippi,g name end ora clarified,poked,
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<br /> b labeled,grid ore in all raspMs in props condifmn For transport by hmghwoy acwrding k applicable inlermlimar and national goveranent reg.4mans.
<br /> v s J a quoNiy gmurata,I carfify Ilial I havn a prop in plea k radon the vohm,e grid kciciry of..ask genaalad k the degree t hwa do:erm reed as be«onomicallY
<br /> c and dmt 1 have sakcted 8,e p attic 6 nethad oh heotment,skrage,a disposal cunamfly available k me which minimizes the pr t and future threw k human heohh
<br /> e:9avirahment;OR,if 1 me a small quo city generakr,I have made a good laid,eflorl to minimize my waste gumma im and select A.best waste management medwd dest is
<br /> "[o me and 1 can afford.
<br /> e SignaNra Mends Day Yea
<br /> LS d aAL fZ f a r
<br /> 1Ac tof e---i dMaterials
<br /> 41 1 Sigmkrc MaMh Doy Yea
<br /> -v CII----, I t0 1 o 2
<br /> ,a' "2 emeM of Raei o(MaMials
<br /> yA;a. Iryp Name
<br /> Signature Month Day Year
<br /> �eDaLrepancy IndkUlims Space
<br /> tib c, ate,Cerci' 'm ojff ,.i of hazardous m.I iab ed dsi i in Mem 19 _
<br /> 7O NOT WRITE-BELOW. THIS NE.
<br /> A[1/991 - _ White: TSDF SEN TMlS COPY TO DTSC WITHIN 30 DAYS.
<br /> vs-% 22 To: P,O. Boz 3000, Socmmmto, CA 95812
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