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–r–. .a--EnxirormsmWrroKKhrnAgency <br /> -> >�OmsNo.2050-0039(Expires9-30-99) See Instructions on back of page 6. Department of Toxic Substances Cash. <br /> �nNfe r typo. Form designed lar ase an efih(T 2-Pih6l N -iter. 606195 <br /> Sacramento,California <br /> 1- abranoomeo. <br /> 's US EPA 0 No. Manifest Dw N 2. Page 1 Information in the shaded rats <br /> UNIFORM HA7l1RDOU$ <br /> is not required by Federal low. <br /> WA3TE MANIFEST CAT 0 8 010121314141318 12 11 2 12 c1 1 <br /> 3. Geemaro,,Name and Mailing Address w <br /> PA22095584 <br /> CIFIC IFIX, <br /> ro PO BM 5095, ROM #3E OOO � a>6.... -. . . <br /> i a- Geaeratoes More I" RAHON CA 94583 (915 <br /> 1h�ATI0d4 & 6. US EPA ID Humber :id.se ao t)7 <br /> m <br /> RQ9FDIATIOl4 Imo. CAD 0 6 3 5 4 7 9 9 6 : ": • 24KI-1196 <br /> 7 6ansperhr 2 Company Nam. B. US EPA ID Number <br /> t 9. Designated F.cdiy Nome and Site Address 10. US EPA ro N miber <br /> i Roeic F2Rvi3cf =ental Tecbmlogies 3 6 I-r 111 <br /> eea 2081 Bay RDW H <br /> 10 <br /> East Palo Alto CA 94303 CAD 0 0 9 4 5 2 6 <br /> 0 <br /> 151711, <br /> •? an . - <br /> 7 71. US DOT Dascripliao(including ProperN.,Shippirg N ,Hazard Class,and ID Number) 12. Ctainers 13. Total IdUnit <br /> No. Type Ouantiy �kt/Vol 1 Wash <br /> VAS9'H PLAMMLE LIQUIDS, 1.0.5.IGASOLINS, OI18®n), 3 011993 PUII sat. 213 <br /> G RQ (D018) 8l6#1128) O o T T / 0 10 ()1 G ESA'—DOM <br /> State <br /> co E <br /> R EPA/Other <br /> i A <br /> > T c State <br /> O EbA/OIIwr <br /> — R <br /> d. s §tile <br /> R u <br /> EPA/O11w <br /> W <br /> '? Add <br /> a <br /> j ) 35180 t;aied Abm. <br /> 1 <br /> L <br /> 15. Speclol Ha dinginsavcroas and Add6on llnlormoron -- 5 fT� ��� �� = ),�2.0 w.�Ls+✓^F`3� 71 <br /> URG90 118T01SH CALL 18001 947-7701 <br /> Z F(ZTL91j til G.H <br /> 16. GENERATOR'S CERTIFICATION: Thereby declare lhal tlne cmtanh o{Ihis<ansi tan hslly and«wra described above 6y propershippng name and are classified,packed, <br /> marked,and labeled,and are in all respects in proper condition For hm,,o by highway«cording to app.cable international and national government reguhhoru. <br /> I d 1 am a lag q tity generator,I erti{y the I time p ram in pl«e b reduce the.plume and roxi<iry o{waste ge ted b the degree I time determimd ro be momiwlly <br /> y+ practct ad that 1 hove n6cfed the prmfcab6 methocI treatment,storage,or disposal currently mailable ro me which minimizes the present and future threat to human health <br /> and 1M environment;OR,if I am a small quantity generator,I have made a goal faith effort to minimize my waste generationond select the best waste management method t6o1 is <br /> « aenilebl.roma and 16011 can afford. <br /> O <br /> Printed/Typed Nome JOSEPH STRgLK ov (jE/>/AlF Stlleatute Mantln Dol Year <br /> 1 <br /> or Rvvmr 0CLP4 ao I Z z 7 101 Z <br /> T 17. Tramsporme 1 Aclum,,riecignment of Ilaxeip,of M ,xriab <br /> R <br /> W Prinhd/Typed SigenNn Mmth Day Yen, - <br /> L <br /> t! R 1 . Tran rhr 2 A<km emenf of Receipt of Materials . <br /> V 1 P,i.W/typed Home - siga lon. <br /> W E Month Day Wear <br /> ✓t R <br /> i 19. Discrepancy Ird'Kaion Space - - <br /> IF j <br /> .! A <br /> C <br /> 1 <br /> L <br /> ` l 20. Facilit,Ownser' Cm tiliorlim of r"pt a hazardous materials covered by dnis..Fest excesst as acted in Item 19. <br /> T Printed Sigmtar. e-7� Mmdi Day Ya <br /> ` DO NOT WRITE BELOW THIS LINE_ <br /> ')TSC 0022A 11/991 White TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS. <br /> PA 8700-22 - To: P O. Box 3000, Sacramento, CA 95812 <br />