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3. Generator's Name and Mailing Address <br />AGLF SL 6L,1- A.00 3 00 <br />Q p.o. 3c�x Sd S spAffiodn c :$3 <br />LOI�(Q) 7 - i777 <br />u] 4. Generator's Phone <br />N 6. US EPA ID Number <br />N 5. Transporter 1 Company Name <br />C? E:cotogy Control Indusldes �C A Q4 9, 8, , <br />C> <br />0 <br />00 <br />Q <br />�Z <br />CK <br />-O <br />�a <br />�V <br />�Z <br />G <br />E <br />o N <br />a°Oo E <br />-4 R <br />44 A <br />o T <br />m a <br />R <br />LIJ <br />W <br />U <br />w <br />U) <br />Z <br />O <br />Q_ <br />Ln <br />U.1 <br />o' <br />Q <br />Z <br />0 <br />a <br />Z <br />LU <br />Q <br />V <br />7. Transporter 2 Company Nome B. US EPA ID Number <br />Q in a { to <br />IMMSTRIE—S 10, US EPA ID Number <br />2M PARR 3L VC- <br />1i''RICIAM00 ! CA 94801 <br />1. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Numberl <br />VVASTE EMPTY STORAGE TANK _pt f'^JC� t <br />NODI F?1%"r'RA HAZARDOUS v%1AST� SOLID <br />C. <br />d. <br />1,7,3 <br />Ire—I. <br />jr <br />15. Special Handling Instructions and Additional Information <br />'wear proper protective equipment while handling. Weights. .or volumes are approximate. <br />24 Hour emergency telephone number; <br />171 <br />24 Hour emergency contact: (6 -177 - 7 7 �[�T E�1ed c d, <br />15. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, <br />marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and notional government regulations. <br />IF I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxic% of waste generated to the degree I have determined to be econom'Icall <br />practicable and that I have selected the pract cable 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 f am a small quantity generator, I have made o good faith effort to mimmtze my waste generation and select the best wash management method that is <br />ch�: available to me and that I can afford. <br />O Month Day Year <br />Y <br />F <br />Printed/Typed% mno1 <br />7- <br />A <br />u1 <br />T <br />Slate of California—Environmental Protection Agency <br />See <br />Instructions on back Of po✓ge 6. <br />Department of Toxic Substances Control <br />Form Approved OMB No. 2050.0039 (Expires 9-30.99) <br />type. Farm designed For use on elite 11 2 -pitch) typewriter. <br />52-Og45(a <br />Sacramento, California <br />Please print or <br />1. Generator's US EPA ID No. <br />Manifest Document No. <br />2. Page 1 <br />Information in the shaded areas <br />is not required by Federal low. <br />' <br />LU <br />u7 <br />Q <br />E <br />R <br />UNIFORM HAZARDOUSi <br />WASTE MANIFEST <br />e A- 'r n$ (,7 t� <br />� 16A <br />I i 12- <br />I S 13 <br />I, of <br />3. Generator's Name and Mailing Address <br />AGLF SL 6L,1- A.00 3 00 <br />Q p.o. 3c�x Sd S spAffiodn c :$3 <br />LOI�(Q) 7 - i777 <br />u] 4. Generator's Phone <br />N 6. US EPA ID Number <br />N 5. Transporter 1 Company Name <br />C? E:cotogy Control Indusldes �C A Q4 9, 8, , <br />C> <br />0 <br />00 <br />Q <br />�Z <br />CK <br />-O <br />�a <br />�V <br />�Z <br />G <br />E <br />o N <br />a°Oo E <br />-4 R <br />44 A <br />o T <br />m a <br />R <br />LIJ <br />W <br />U <br />w <br />U) <br />Z <br />O <br />Q_ <br />Ln <br />U.1 <br />o' <br />Q <br />Z <br />0 <br />a <br />Z <br />LU <br />Q <br />V <br />7. Transporter 2 Company Nome B. US EPA ID Number <br />Q in a { to <br />IMMSTRIE—S 10, US EPA ID Number <br />2M PARR 3L VC- <br />1i''RICIAM00 ! CA 94801 <br />1. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Numberl <br />VVASTE EMPTY STORAGE TANK _pt f'^JC� t <br />NODI F?1%"r'RA HAZARDOUS v%1AST� SOLID <br />C. <br />d. <br />1,7,3 <br />Ire—I. <br />jr <br />15. Special Handling Instructions and Additional Information <br />'wear proper protective equipment while handling. Weights. .or volumes are approximate. <br />24 Hour emergency telephone number; <br />171 <br />24 Hour emergency contact: (6 -177 - 7 7 �[�T E�1ed c d, <br />15. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, <br />marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and notional government regulations. <br />IF I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxic% of waste generated to the degree I have determined to be econom'Icall <br />practicable and that I have selected the pract cable 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 f am a small quantity generator, I have made o good faith effort to mimmtze my waste generation and select the best wash management method that is <br />ch�: available to me and that I can afford. <br />O Month Day Year <br />Y <br />F <br />Printed/Typed% mno1 <br />7- <br />A <br />u1 <br />T <br />17. Transporter 1 Ac <br />Printed//TTypped�Name <br />aC <br />6 <br />sl <br />T'EAAJ <br />w <br />'9 <br />18. Transporter 2 A< <br />Printed/Typed Name <br />0 <br />R <br />T <br />LU <br />u7 <br />Q <br />E <br />R <br />erlaement of Receipt o <br />V 19. Discrepancy Indication Space <br />DTSC 8022A i 1 /991 <br />Signature <br />Material: <br />I Month Day Year <br />Signature I Month I Day I Year <br />cos materials covered by this manifest except as noted in item 19. <br />5ignat�i CEJ} Mont? Day Year <br />1 q M C <br />DO NOT WRITE BELOW THIS LINE. <br />F <br />Z <br />_ <br />A <br />C <br />I <br />L <br />1 <br />20, Facili Owner a <br />T <br />Y{vcD <br />Printed/Ty ed Name <br />DTSC 8022A i 1 /991 <br />Signature <br />Material: <br />I Month Day Year <br />Signature I Month I Day I Year <br />cos materials covered by this manifest except as noted in item 19. <br />5ignat�i CEJ} Mont? Day Year <br />1 q M C <br />DO NOT WRITE BELOW THIS LINE. <br />