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ta-,jnJrcbMRenifr a^"Ba"cY See Instructions on back 4e 6. Department of Toxic Substances Control <br /> OMB No.2050-00391Exp res 4-30-99) Sacramento,California <br /> ape. Farris designed kr ase`sn eliN(12-pitch) writer. <br /> x . Ganuator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br /> 1 <br /> UNIFORM HAZARDOUS is not required by Federal law. <br /> WASTE MANIFEST <AIVOIR61610 of <br /> i�' 'est Dacumm+I Numhx <br /> 3 Cledler is Name and Mailing Address : j"� <br /> PACIRC BELL L <br /> P.O. BOX 3093 RM3E000 SAN RAMON ,CA 94583 B, s ok pe 9 a o1s A) <br /> 4. Generators Phone 1 916977-7777 <br /> Name <br /> ,y- 5. Transporter I Company <br /> 6. US EPA ID Number C. State Trbnsfet, 'sjJTlReservedj <br /> " 1 7 3 D. Yro"e =Its 06.41 <br /> €CCLO^vY C'vFITIiOL i�iDL'ST4i€S <br /> 7. Transporter 2 Company Name 8. US EPA ID Number E. Stab 4onsparier'i 1D 1Resermd I <br /> J F 7ronsperbrs Phtme <br /> J 9. Desi9ZFociliry Name and Site Address 10. US EPA ID Number G $isle Fail' f <br /> Romic Environmental Technologies <br /> Z P <br /> F <br /> 2081 Bay Road x. oal FF. lw e <br /> East Palo Alto, CA- N303 10 ,11100094S 12 Containers 13. Total Id. Unt <br /> 11. US DOT Description(including Proper Shipping Name,Hozord Class,and ID Number) No Type puantity Wt Ystp Pt9 <br /> Z Sig48 ` <br /> NON RCRA HAZARDOUS WASTE LIQUIDS EPAyOI�r <br /> c DIESEL AND WATER MIXTURE O 1 TT 06 a1c)10 <br /> E State <br /> o N b" <br /> m E EPA/Other <br /> R <br /> A Sob <br /> o T <br /> ado O Ardlltif t <br /> R � cT. <br /> Z <br /> V 34! <br /> 1 - KNlradlirlg Audi+bur Weptns 4s A�a+e a s % <br /> W s`rtik`4 dT <br /> �Yr`.. <br /> O Special Han 11m Instrapio sand Add I nal lq(ormat o <br /> tear ap�r�opna�e pro1ective clothing when handling. <br /> 24 Hour Emergency Telephone Number: 916-977-7777 ECI JOB# Say 3 03 O J. <br /> . 24 Hour Contact: PACIFIC BELL DISPATCH RES. CTR ERG# 171 Fre- ,CT a-, <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of th i s consignment are fully and accurate)y descr bed above by proper shipP ng name and are closaif ed,packed, <br /> Q marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and nahanal government regulations <br /> If I om o large quontiq generator,I certify that I have o program to place to reduce the volume and toxicity of waste generated to the degree I hove determined to be economi"N <br /> sn practiwBle and that I have selected the yrl <br /> acticable 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 I am a small quantity generator,I have mode a good faith effort to minimize my waste generation and select the best waste management method that is <br /> woilable to me and that I can afford. <br /> Printed NameC �I Signature _ Month Day Year <br /> m i j7.Trans oiler 1 Acknowled a ant of Recei t of Moteriob <br /> Printed/Typed Nome m Signora Moath Day Yaar <br /> S dH <br /> O <br /> P <br /> sr_ 0 18. Trans orbr 2 Ackno ed ement of R«ei t of Materials <br /> O R Printed/Typed Name Signalme Month Day Year <br /> T <br /> E <br /> R <br /> 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> 20. Facili Owner- O orator Certification of receipt of hazardous materials covered b this est except as noted in Item 19. <br /> T Printed/Typ ante Signature /l Month Day Year <br /> y ttn2 b>~ t ` C b L <br /> DO NOT WRITE BELOW THIS LINE. <br /> White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> DTSC 8022A 11/994 - ' To: P.O. Box 3000, Sacramento, CA 95812 <br /> EPA 8700-22 - - <br />