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State of Cali(omia--Environmental Prabstion Agency " <br /> Form Approved OMB No.2050-0039 lExpires 9-30-991 See Instructions on back of le 6. Deparfinem d Toxic Substances Coma <br /> Pleosa print«type. Form designed ler use m dib 112-Piklrl h tee- <br /> Sorr.rner,a,California <br /> UNIFORM HAZARDOUS ^erator's - _ -Manifesl D«aawntNo. 2. Pog.T Mfore-tion in the shaded areas <br /> is,WASTE MANIFEST � G ? 9 Q ! of 1 in required by federal hw. <br /> 3. Generalars NarAord Mailing Address 17ACg0/ - A S'toleldmNasf Docum«�t Numbed - <br /> ` P•O. Box 509 Rosin 3J:oOo 21 . <br /> SAnP.Amvy% cA 91q583 B saaG«.aw ,ID , <br /> .. Gen«afee.krone 19/6197-7—7777 J 111 <br /> Y..sV 5. TrauporM 1 C«npany Name 6. US EPA ID Number C. State Tronsposbr's ID fResesved.l <br /> Ecology Control kldEWf*S A 0 310117 3 0 Tr9mpartees M. <br /> ro 7. Transports 2 C esp«ny Name s 8- US EPA ID Number 'E:Stab imnsporM'y ID[Reserved I <br /> F Ire spotters Pl�ona -- <br /> 'tt<!1 9. D Nome and Sale Address 10. US EPA D Number G State F fere ey's 10 n ` <br /> i Romic Chem"I Corporation I1J- 1 1 1 1_LI_( <br /> '1;R 2081 Say(toad H Facihty',Phone <br /> )S East Palo Alto CA 94303 ic i A 0 Q Q q 4 2 6 5 7 650424 L I73 $ <br /> 12- Conwiners 13- Total la. Un <br /> 1I. I15 DOT Des«iption lincludirng Proper Sfiippiag Name,11a Class,and D Number) No. Type Ouanny Wt/vol 1 Wasty <br /> AS7EF1JW"AhLA LfyoD5 Sk�ie 31 <br /> Re. <br /> � .uoa„3iun1993�pbUl ^ <br /> G 100/ t PrnE.'/t.'35`1f T� 0 W EPA/oThuL34LH13 ' <br /> N As. <br /> a <br /> O E <br /> R EPA/Of <br /> -a <br /> A <br /> a e <br /> 9D O EPAR41-1 <br /> R <br /> L1 d. <br /> LL_ <br /> n --.>'_ 's for Mmxrid3 Eared hbove ` x1 <br /> s •- ",, IC iiainiing Coda for Wastes _�ltbwe ---"T <br /> o. b <br /> W R6GRf?$C3NS 70 1000A _ <br /> _ s m`cA�1 ,semi, <br /> Lie r prop"'er�pr'o ec' Ive Aulpmen Vhile handling. Weights or volumes are approximate- ERG#11 a 128. <br /> 24 hour emergency numberlIA5 A 77-7 777 SITE LOCATION- 7;14fd WJAV5&10 DrR✓e <br /> 24 hour emergency contact PAcEetiw'0ttu toCa, <br /> Rr T 6 <br /> a 16. GENERATOR'S CERTIFICATION: 1 hereby declare flat f6 contents of his consignment are 611y and ocur sc <br /> deribed above by propershippng Home mrd are classified,packed, <br /> s t marked,and labeled,and are in a0 re,pects in proper condition hx konsport by highwq au«ding w oppliwble inrernafional and nmiond govermnent ragukfi.., <br /> If 1.a tang.quantiy ger�enats,1 certify th«I ha.<a pr tom in place b reduce gin wlume and bxiciy d web germratd b the degree I have determined w be ecanomicdly <br /> We: prokable and that I h selected Ave pr«Iicable method d treatment,storage,«disposal cummlly woilabl.b me which minimizes the present and future threat to h.n h.K <br /> and the serviron.1;OR,if I are a smell=fiy generator,1 have mode a good faith Had Is,minimize mf wash generation and select dm best web management method dna is <br /> a v'lable ta me and that 1 inn of en& 1 <br /> Prin <br /> Sign ii,/. r • 'r Akanrll-_ Year <br /> W 1 17. T I Adnowled of R" dAbbrick <br /> O <br /> -� ; Prinled/Typed Nam. Fee►�e� p�C�►�E{�.. ssgnalur. Munfb Day Yea <br /> 1 S , 7 10 a <br /> .4L 'I <br /> O . E 18. T 2 A< t d Roe' dMatsidr <br /> R Prinled/1 <br /> W [ feed Nana - Sig«swn - Month Day Year <br /> R <br /> 1 F 19. Drecreor <br /> paacy Indication Sp.. <br /> — A <br /> C <br /> 1 <br /> L <br /> r 1 1 20. Fessilit,Ower or OperforLerfilk.fi. I receipt of hasardous matsidi covered Isy dtfs nanih t saospf as naiad in pore 19. <br /> T PrinRed/Typed Name signafum _TjMonde Day Year <br /> Y <br /> s DO NOT WRITE BELOW THIS LINE. <br /> 4SC 9022A 11/991 - - Whit.: TSDF SENDS THIS COPY TO DTSC WFTNIN 30 DAYS. <br /> PA 8700-22 To: P.O. Box 3000, Sacramenla, CA 95812 <br />