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Cafe dcalifarnid--Emvira'rnenfd Pro"" See Instructions on back of r X6195 ospartnmet d Tox;c Substance,C-0-1 <br /> om Approved OA.1No.2050-00391E.O.9-30-991 - sacramena,Cnlilomla <br /> sTlpau 'M.b type. Farm designed For au on dib 112pitdl h �� <br /> _ I. P 1 M(ormallon in IM shaded ar°as <br /> 1. Generator's US EPA ID No. Mondnl Doc°menl No� is rwt required by Federal low. <br /> UNIFORM HAZARDOUS C A T 0 8 0 0 1 9 9 4 6 8 2 1 0 5 of 1 <br /> WASTE MA INFEST ('�-[ '7 <br /> 3 �C ,A�.t.ns Addre„ A Baa bo Dame t N-6. <br /> 9 0 0 J J g A 1 <br /> PO BCI% 5095, ROCK #3MM Sas Genera ds ro <br /> SAI# RAIM CA 94583 (115 )413 <br /> n 1. Generator'.PhoneAll 1 1 <br /> d. US EPA ID Number a Trensporar's ro( _ <br /> n MMMjATTOIj INC. C A D O 6 3 5 4 7 9 9 6 D- r a�� •a'"n° <br /> e <br /> Number 7. <br /> Saa Tmnsporpfs ID R u. <br /> t <br /> 7. Transports 2 C.Peny Name <br /> U <br /> 10. US EPA TV Number <br /> G State <br /> 2081 Bay Road 415) 324-1638 <br /> p Fast Palo Alto, CA 94303 CAD 0 0 9 4 5 2 6 5 7 <br /> 0 - 12. Conminers 13. Total Id. Unit <br /> s•V 11, US DOT DescriPtfen fi«ludirg Proper Shipping Name,Hamid Class,end ro Nwnberl Ne. T �a^fiN <br /> Wt/vol 1. Wash N9mber <br /> Z UA3TI nANABLI LIQUIDS, I.O.S.(GASOIIII, DIISBL), 3 01993 MI sok 213 <br /> `3 G RQ (Dole) BIG#(121) <br /> 0 0 ( T T F 2 G <br /> Sense <br /> E <br /> O N b, EPA/Olh« <br /> m E <br /> v R Sale <br /> r a A <br /> O T EPA/00. <br /> m O <br /> R Sate <br /> bee W r d. EPAIOIher <br /> z <br /> W <br /> U Cade,fu Wastsa Usted Abma <br /> kee <br /> ° P� <br /> F. 359 8x 7 f" <br /> N <br /> w a. <br /> 0 I5. Sp«iol Handling In,Iructions and Additional Informafion l.�, {A9 �♦rS5 = (� o W�5 i <br /> !a MGM IBSTDoSI GALL (100) 947-1101 5o Jr1YJAt1F- CA <br /> z <br /> e,e W <br /> is d this const ment ars lolly nd accuratelIyy described above by proper shipping name and are clessilied,pock , <br /> 16, GENERATOR'S CE no": 1 hereby declare dent dte cantsn ggn^hl h according a applicable intenwfional and rwtiond government regulation . <br /> Q mmked,and labeled,and are in oil respects in proper condirion lar ryse"Pen ly a "'OY <br /> ei° U ti roto.1<mtily that 1 baro a Pr gram in place a reduu the vduma a�td aeiciy of wosa g..,.I.d a the degree 1 have determined a be acorns hZ y <br /> ty ge method oaf treatment sarags po handy avo0o61e a me wh;d minimises the pr ant and fuare threat a human heel <br /> d H 1 a cable and that 1 have elected the oucficable 1 have made o good faiths dM a minima my wosa garterafion end ul«t the best waste mon.gensem method Ihat is <br /> grid the environment,OR,if I om a small quanfity gmseraar, <br /> ce aveilabk a me and that 1 can oHord- Month Day Yea <br /> 0 <br /> y 0 O' <br /> e y Prin /Typed Na_ 112 <br /> z Pdltb 0 NS <br /> z <br /> W 7 17. ran rM 1 Acknowl ant of R«ei d MoMiah - Month Day Y. <br /> w A Min <br /> W R <br /> r f S <br /> . W PMonth pay Ya <br /> LL R IS. Trans 2 Acknowl menl d K«—P'Alofarids' SigrwNre <br /> 0 1 Pri.t d/Typed Name <br /> W E <br /> N R <br /> Q 19. Discrepancy lndicofion SPnce <br /> U <br /> z f <br /> — A <br /> C <br /> I <br /> ber E Merrill, pay Y. <br /> 1 20. f«il; Ow.sar or roar Certibufion d reu; of hazardom <br /> materidc<overad this manifests« inn° in Hem <br /> S;gneNre p 3 s Lo- <br /> y Pr;nhd/Typed Name �^ - <br /> Y <br /> I. - DO NOT WRITE BELOW THIS LINE. <br /> wlb"e 15DF `_ENDS THIS COPY TO DISC WITHIN 30 DAY: <br /> To PO 3oe 7000, Sacramento. CA 95812 <br /> ` DTSC 8022A 0/991 <br /> EPA 8700-22 <br />