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" oL(orma--Enviranmenlal Protection Age," <br /> run Approved '2050-0039(Expires 9-30991.-_- .-__ -__. See Instructions on bock( of 1` .6. Department of Toxic Substances Can, <br /> rese ease print or type._Fo,m deagned/or_use vas elib(LLZpikhf,07v�/rte.—.�__._-��.._�__ .. ....__. 1.0606195 Sacramento,California <br /> 1. Generator's IIS EPA ID No. MamYW Document No. 2. Page 1 Informalian m the shaded anions <br /> UNIFORM HAZARDOUS is act required by Federalhw. <br /> WASTE MANIFEST C AtT10 81010121 6 3 1 3 8 2 10 19 13 of 1 <br /> ` 3 Gmeratw.Name and Mailing.Addmss mWPr O9,J�V. <br /> PACIFIC MJ <br /> PO BOX 50� T9�5, ROM #3F7 W § <br /> A. Generator's.Phone InY, VAMN CA 94583 (925).823-8866 <br /> 2?Ii3l3aG1TNAlil�P 'ATION &. 6. US EPA ID Number1748 <br /> m <br /> MIMIATION, M. CAD 0 6 3 5 4 7 9 9 6 (408}268-1196 <br /> - - <br /> ` 7 Transporter 2 Company Name - 8. I15 EPA ID Number <br /> 9, Da,igaated Fac lit,Name and ess d4 Site Addr10. US EPA ID Number <br /> ToGhn"efftes- 15" Ai-r r h`. <br /> acFmad <br /> F3ax T <br /> FwF Palo Alter-GA-94-3G3- � - <br /> rdr' <br /> 11 OS DOT Desch fi. ndudi Pro Shy - 'tJame,Hazard Class,and lD Numbed - 12. Containers 13 Total 14. Unit - <br /> P li ng per yping ---N-.--T—Typ. Quantity Wt/vol <br /> a WASTE PLAMML$ LIQUIDS, N.O.S.(GASOLIII, DISSEL), 3 011993 PGII (, ' V <br /> G RQ_-jD018) nG#(128) G)101T T O 313 G <br /> e <br /> lop <br /> E b: <br /> fi J a- <br /> s, E 3` <br /> RNP . . -., '- <br /> T C. s; <br /> Z) O <br /> R Aw <br /> d: s <br /> I an F r,Naerml ti td'Aba eJ '{, i- '�' _ + . . 4A. <br /> it U1L bIID'1I1 SAII tSl TbI10L �� M M <br /> A «yam Es L+_ kt c- Y <br /> Y <br /> . <br /> t <br /> ..15. Special Handling Instructions and Additional Informing. <br /> Q 8ffiG®CY MORSE 0161 (000) 917-7701 <br /> -5�Jo9t6 f eA <br /> Isse <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare tlsul the contents of this coni Cent am fully dad accarably described above by proper shr'pping..and are classified,packed, <br /> Q marked,and labeled,and ore in all respects in proper condition For transport by highway according m applicable international and nogarml govemmmt regulations. <br /> 11 I am is longe quanliy gmeralor,I certify that 1 have a pr ram in place to reduce the volume dad toxicity of waste generated m the degree I have determined to 6e economically <br /> n practicable and that I hhave selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment;OR,if 1 am a small quantity generator,I have made a good faith effort to minimize my waste generation and salsa 16 best waste management method that is <br /> z available to me and that I can afford. <br /> Nth Yeo, <br /> Printed typed a Sign m ,s_ � I Z I Day Yen, <br /> O <br /> ��. a `JV'1 <br /> r, 1 17. Transport.,7 Acknowled emenf of Ris of Materials <br /> R Yea, <br /> R Prinhd/Typed No Signa ne Month Day// <br /> S b w Z ( O <br /> 9 18. Trosexpenter 2 Aclamwled mem of Receipt of Materials <br /> TPrinted/Typed Name Signature Month Day Year <br /> E <br /> 1 1 Z <br /> 19. Di Indicmi.5 ce -IYWr#N1 <br /> z F saeponcy Pa V�i�'!Y�{CA-�s:.C:.l i}.j r <br /> _ p • gc,rli )cnviTonwvwrlf[.ly TPIe <br /> �� � VMS <br /> � beeatls>�-�,man eentoi <br /> /fi�a1,rAa A w 602o257�1`($ <br /> L <br /> t 20. Faci? Oomer. for Cedificag f receipt of hazardous materials covered b this manilest exc as no in I9 <br /> T Printed/T Signature - month Day Year <br /> T (34 <br /> 7. _ y <br /> r DO NOT WRITE BELOW THIS LINE. <br /> While: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS.- <br /> iSC 8022A(1/991 To: P.O. Box 3000, Sacramento, CA 95812 <br /> A 8700-22 <br />