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Sine of oshlomia—Eiwironme nal Protection Agency <br /> -nm Aepoved OMBNo.2050-00391Ezpires 9-30-991 - See Instructions On back Of p- '? b. r Deportment of Toxic Substances Control <br /> pnrnt or type.."Yoim designed for use on elite(I2-o'-kh) v. 195 Sacramenro,California <br /> r 1. Gemzvwls US EPA ID No Manifest Dacument No. 2. Page 1 Information in the shaded areas <br /> UNIFORM HAZARDOUS is act required by Federal law- <br /> WASTE MANIFEST C A T O81010121413101 8 2 0 9 8 of 1 <br /> 3. G.W,Name and Mailing Address '`ept`jNum6er O <br /> r PACIFIC M-1 5 <br /> 56 <br /> o PO BOK 5095, R" #3FEKIO0 ; <br /> A..7Gesne�mwyrs Ph.�,#p1�p�RA#1ON CA 94583 ( l )gL3-�v/- 1__L._�_L- --- <br /> r kftTAV"%bk ftftlATION & 6. US EPA IDNumber 'ik. ]748. <br /> nn 11(/Sl� `t --- <br /> C? <br /> _m RF2lm7ATION, INC- CAD 0 6 3 5 4 7 9 9 6 )26.8-1196 YF <br /> 7. Tronsporw 2 Company Name 8. US EPA ID Numberbee ? <br /> I `It <br /> t s 9. Designated Family Name and Site Address 10. US EPA ID Number b <br /> SE6 /}L'r FA-C C C f-c y �.0 r "r I-1-_f J 1_1.. L <br /> Qox 5 <br /> 0 <br /> Y- 12. Gonroiners 13. Total Id. Unit <br /> 11, US DOT Description(including Proper Shipping Nome,Hamid Class,and ID Numbed No. Type Ovmfity Wt/Vol � I <br /> u. h-vx <br /> F a 6ASTS FLAHUL6 LIQUIDS, 6.O.S.(GAS un, DISSML), 3 061993 ?GIIr UO =213 <br /> G RQ (0011)- &RG#(128) O O t T T G <br /> 'Vm N b <br /> m E <br /> e _ <br /> T <br /> m O <br /> R <br /> d.st <br /> §: <br /> u <br /> see <br /> 0 <br /> y <br /> 15. s . I H—clir,In:auctions and Additional Informafion _> <br /> p"'a -Sin-v' Jn,'091 's = 4)0% 21 <br /> #MH8G86CY RMSPOME CALL (800) 917-7701 GA <br /> lee <br /> Q 16. GENERATOR'S CERTIFICATION: I hereby declare that ihe..t.tz of This mnsig meat are fully and oc.0 ly described above by proper shippiag nom.and are d.,ibed,pocked, <br /> marked,and labeled,and ore in a0 re:pea:in proper condition for transport by highway ac.rdirg w oppli<abk intcmafional and notiorwl govarmnenr regulaRons. - <br /> If I am a large quantity genemror,I.rtify that 1 have a program in place ro reduce the volume and toxicity of waste generated In the degree 1 have determined ro be economically <br /> n pia 66,and drat I have selected 16 octi.ble method o treawwnt,storage,or dispasal cu available w me which minimizes the present and future Ihreat to human health <br /> Y and da emironmenY OR,if 1 om a small quantity generator,i hme made a good failh effort mini 'ze my eneration and select the best waste management method that is <br /> avoilobk In me and dal I.n afford <br /> Prinhd/Tyts�d, s Sigrawre Month Day Year <br /> rTi P" I2 9 2 <br /> j &T17. 1 Ac .led a enf of Recei r of Materials <br /> z. APrin /typed i9 re Mends any Year <br /> R <br /> S <br /> P <br /> D <br /> R 18. Tion 2 Acknaw ement Receipt of Materials <br /> It <br /> Prinled/T Name Signature MonBs Day Yea <br /> u L <br /> R <br /> P 19. Discrepancy Indication SpacePt <br /> ,�( ©� K 6�;}.s.( _..._7N.h P-W J<e y &"2CIjky <br /> A Roe hesfc.n ;n Yf�-vas a curl:� tsn E�JiconewrfEL/ L c <br /> C 41a I f7pJ ttxa.,d.r <br /> L <br /> ems' f 1 20. Facility Owner or aror GrtiF.ti of receipt of Mmrdous mawrials covered by this manifest az<no as Hated in Nem 19. <br /> 1 T Printed/iyped n Signature Gs Abnth Day Year <br /> I Y 2 6 L <br /> DO NOT WRITE BELOW THIS LINE. IZ Z l 62 <br /> SC 8022A 11/991 Whits: TSDF SENDS THIS COPY TO DTSC WITMN 30 DAYS. <br /> A 8700--22 To: P.O. Box 3000, Sacromento, CA 95812 <br />