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�w m laliM-nla—[nvirannlenal rrownon Agemy <br /> re Approved OMB No.2050-00391E.pbes 9-30-991 See instructions on back of p- x 6. Department of Toxic Substanam Control <br /> ase pinta type. form designed For ase on elite f I2-pitch)typ_r:. Sacramento,Cahform. <br /> UNIFORM HAZARDOUS I. Dermatoe,US EPA ID No. Manifest Do moment No. 2. Pogo 1 antmatiam in the had�d areas <br /> CA 7—O equi ed by Fede al law. <br /> WASTE MANIFEST O 2.1 6 8 - ` d <br /> Gmmob/s No.and M ifing Address �dleRbae <br /> Pacific Bell <br /> P.O.fox 5095:Room 3E000 San Raman CA 9d� r ��_ <br /> A. Gmm,.W.Kana I _ 1 „, r <br /> a 5. Transports 1 Company Name 6. US EPA ID Number x • s <br /> m 1. dsi: <br /> •c U <br /> 7. Tronsporhr 2 Campsry N. <br /> f <br /> Q <br /> 9. D ig aMd Facility Nome and Sit.Addrss 10. US EPA 10 Number <br /> 'Z Ramic c hamicae+i T.omez^aff6 <br /> O 20&1 BW Road _ <br /> 11. US DOT an mdudln Pr Shipping No.,Nazard Caw and 10 Number) 1 mints 13. Tool 1�. Um <br /> _ D•+r^P^ f 9 �v� Pv^re Na. h� _ wanriry Wt/V-1 <br /> Z a. <br /> x <br /> O <br /> E MORM <br /> N G✓,+sT �•vm�rfi6/< L+"vs—, &I sr 3, 1/*/993 <br /> R , �Ofx�l� ooiBry / T T <br /> A <br /> e T <br /> m O <br /> - R a' <br /> Al <br /> W <br /> U <br /> 1 <br /> •D 15. Stmcial Handling Instractions and Additional Information <br /> G tear proper YiutccLRiVE equipiiicria JtiFFiFE haFiuliPFy ViEiyfPw or volumes are raFPyTuniiiiaac. 24 <br /> Hour emergencv telephone number 1-916-977-7777 (Pacific Bell) ERCT# 128 <br /> /N A RAS _:L� .JJ—���. i N <br /> IrW&r1t'A16r1 CERTIFIU I e6y re at a conrenb of Ihis consi8nmem are fully and accuramIy dascribcd above by proper shippng name and aro clossiAed,Packed, <br /> Q maned,and k,b.W,and a,.in.B respects in proper condition for transport by highway according to applicable international and national government regv,fionr. <br /> T <br /> u If I am large quanliy gen raw"I certify that 1 have program in place m rndo.the vol ms and to.iciy of waste generated to the degree 1 have determined to be ecoramicallIyy <br /> practicable a�the I Awe mlecmd Ina pprocticabk me8ad d treatment,swag, dispo I currenAy avail w.ro me vF..ich minimizes A r sem and fatara threat to humors haalAs <br /> and Ase environment OR,if I am a unall quantity gmermor,I have nodi.o good faith effort m inti.my w e generation sad sets a bast wort.macagemsnt method Aat is <br /> a nA.61e to me and Arm I ca afford. <br /> Printed/TYped Na aW C'--M 1 Signature / Month lhy Year <br /> -�' G{)i l O <br /> W 1 17. Iram,porlen 1 Ak.6dg..l of Rsei t o tench <br /> RPrinPed/Typed ry^-ma Sigr.w'. Month Day Year <br /> lor <br /> LL P 18. Trans partar 2 Ackn ement of Rec.i t of Matsiah <br /> O IT Printed/Typed Name Signahae Mon h Day Year <br /> � R <br /> 19, Discreponcy Indication Space <br /> Z F <br /> — A <br /> C <br /> 1 <br /> L <br /> l 20. fa,dij,Owns or rami Cstihcotton of rsei d hazardous materials cowed bY Asia amifext e.c t as notal in Item 19. <br /> rinred/Typed Nome SignaNre MonAs Day Yes <br /> T P <br /> T , �. r' � <br /> DO NOT WRITE BELOW THIS LINE. <br /> White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS, <br /> DISC 8022A 11/991 To: P O. Boz 3000, Sacramento, CA 95812 <br /> EPA 8700-22 <br />