Laserfiche WebLink
S1ae.1 Cd"forn, EmLannentefProhrtionAgency <br /> Form Approved 0166 No.1050-0039(Expires 9-30-991 See Instructions on back of paqe 6. Deportment of Toxic Substance,Consist <br /> lease print or type. Form designed for ase an.fife f12-pisrhl syr ger- S«wmenio,California <br /> ` UNIFORM HAZARDOUS I. atofs US EPA ID No. Manifest/D«umenl No. 2 Page 1 Infatmat an in he healed meas <br /> WASTE MANIFEST / (� �� 7 0( 1 is^° requbed by Federal her <br /> i 5) <br /> 3. s Name and hbili. AA�d�jn'sss A <br /> J/` 3tobManilasl DccwiaM Numbv 219-96787 <br /> � �� �' s'l�/'r\ �--'•'"— " 3 'f'seneralcr•,w <br /> Yi 1. Oeneroter's Phan.gr(j l qn- <br /> res i 5. Transporter 1 Company Name 6- US EPA ID Hombm Transp9rM'i to(Rosen ed.l <br /> o Ecology controlInonstriesIC q 310111713 D Tromp«tom.vh 510-236-1393 <br /> s 7. Transporter 2 Cannpony Name 8. US EPA In Number E. Stote Tronsporter'a ID(R_'edit -. <br /> F_ Tronsporte/s Plsorm <br /> Q <br /> U 9. Designated f«ihry Name and Site Address 10. US EPA 10 Nm..ber G. state F«Aiys ID <br /> Romic Chemic-4i Coruoration ell <br /> ri2081 E3ay Road x. Fad;y,Ph .a <br /> 'c East Palo Alto ca 94303 2 61517 , 650-324 1638. <br /> 11. US DOT Deeviptian(including Proper Shipping Nome,Hozard Class,and ID Number) 12 Stn issers 13. Total ]A. U.;'No. T Quantity Wt/Vol t. Waste thsmber <br /> ftil� <br /> G. "G- a Aft)h.r <br /> 31t <br /> E b' W TC'd= AMtWkA/3Aj LF' N{"DS,N.O.S. Fdn/993 - ^ <br /> 3i • alt2o Z13 <br /> ,� N �. z _ <br /> m E U,,Aie4tx �li!set) <pool.Dols) / / G EPuoih.. <br /> v R <br /> T $tate <br /> • i <br /> O EFA/OAer <br /> R <br /> W <br /> •� .. ."- '.MawWs Listed Abo a - -.. - -__ K Hnodho,Codes far Wash Listed Above <br /> 1 0 7a b. <br /> PETROLEUM HYOPO0r ARSONS 7056100% <br /> ad W4TER Oa, 30% - c_ <br /> *ES <br /> id H.Ai Ian and Addei.sal lobar. tion - <br /> proper�pr c�l.e equlpmeR vdhlle handling Weights or volumes are approy{rnate 1=R�Gt.�j a 12 J.dC <br /> i 24 hour emergancy nu{lTber. / 4tG q 7'7 777 7 SITE LOCATION, 17�/GeC� <br /> 24 hour emergency contact: �t�tf/C (?,C'GL /�j�(,�J�� /4 <br /> ECI t ZSL <br /> Ito, I6. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consiggnn t are fully and accurate) described above by proper shipprg none Gad era 1. find packed. <br /> Unarked,and labeled,and are in all re,p in proper condition for konspo,by highway«cordiry to applicable international and national 97 ..mem.e re, sa. <br /> If I am a large quomiry generator,1 certify that 1 have a pr r in place to reduce the..fame and toxicity of waste generated to the degree I have determined to be eco•amicdlY <br /> r practicable and bort I Tom selected the practicable metbod of neatesent,storage,or dlspo,al currently available t.me which minimizes the present and future threat to hams.health <br /> Gad the e.usnosent,OR,if I an o smog quam,ty generator,I here male a goad faith e8oti to minimi:.my waste genero6on and select the best waste...agement method that is <br /> °C wrilable b me oral thin 1 can afford. - - <br /> O <br /> Prins /Typal Namehbntls Day Year <br /> - /1 c`71 clii <br /> tat T /7. Trans 1 Ackn mdR of Materials <br /> W E Printed Year <br /> . R <br /> y f <br /> v . 18. Tron r 1 Ack wle re d Recei o Maeriols <br /> 7R <br /> Printed/Typed Name siqrsestdrf Month Day Year <br /> W E <br /> H R <br /> i 19. Discrepancy Indicolian Span r � <br /> lam A LA bcyr / / F' 7'F,C quna...f-'W-y /its ) Ste' Ix/cS CFaa•,eco �rm � <br /> L <br /> 1. 1 120- F«ili Owrm.or rrtw Certification of r«ei t o!hazardous.aerials covered 6 this.wniten e t as oared in Item 19. <br /> T Printed/Typed N SignaNre March Day <br /> Y. <br /> 7:-107 loll <br /> 10 1 <br /> ` DO NOT WRITE BELOW THIS LINE. <br /> - C 8021A(1/991 - - White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> ssTS <br /> TS 87022A To: P.O- Box 3000, Sacramento, CA 95812 <br /> b <br />