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i <br /> Slate of California—Environmental Protection Agency <br /> See Instructions on back GF le b. Department of Toxic Su6stdncn d <br /> Contr <br /> F.,.Approved OMB Na.2050-0039[Expire,9 30 991 <br /> _ <br /> Please print c hype. form designed for use on elite IF 2-pitch) iter. Sacramento,C"Gbani s <br /> 11110_A IGenerator's US EPA 10 No. Manifest Document No. 2 Page I Information in the shaded arms <br /> UNIFORM HAZARDOUS is not required by Federal low <br /> . <br /> WASTE MANIFEST 1- 0 O ,S 6 6 al 1 <br /> 3. Generator's Na"} and Mailing Address A. ticite Manifest Document Number 98166810 <br /> JOI V\ (_rj t"(2 �?til Lr._._MW�r <br /> en ✓ I (� \_ t C B Slate Generator's ID <br /> � nin ru - I C�• <br /> sn d. Ge nut's Phone I Ljn <br /> tV 5. Transporter I Company Nome 6. US EPA ID Number C. State Transporter's ID <br /> h <br /> 0 <br /> ASBURY ENVIRONMENTAL SERVICES D. TramporteisPhone 131e1886-3400 <br /> m 7. Transporter 2 Company Name 8. US EPA ID Number E. State Trmsporter's ID <br /> F. Tramporbr's Phone <br /> Q <br /> (�U 9. Designated Facility Name and Site Address 10. US EPA ID Number G. Slate Faciliys ID <br /> T-4:5 RANDS ENVIRONMENTAL0AID10440013151!3161 <br /> OO aZ, ISIS MM RIVER WAST SR WMWO,CR 9569] H. Facility's Phone <br /> �p ` 19161371-5747 <br /> 11. US DOT Description(including Proper Shi Name,Hazard Class,and ID Number) 12. Conminers <br /> V P (t 8 P FFA"8 No. Type Ouonnty W,/VdI I. Waste Number <br /> OO= stare <br /> a. NON-RCRA HAZARDOUS WASTE, LIUUID <br /> tut- (WATER,OIL) EPA s. <br /> 3 G No Placard Re utred 1 T r NONE <br /> o N b. swro <br /> m E <br /> R EPA/011i <br /> v A Stan,o T <br /> mO <br /> _ R EPA/cher <br /> w of <br /> d. Smro <br /> Z <br /> Z <br /> w <br /> V EPA/011ier <br /> W <br /> J. Additional Descriptions 1a Materiab Listed Above r IY.jj C'es or Wdf1h Ust Above <br /> Z 6. <br /> sn 3N <br /> w ss�+}sw <br /> CML <br /> Q15. Spacial Handling instructions and Additional Information 0001 1a <br /> F <br /> Z GLO"S [ F3Or79LfSt3 �0FO6NCY COWACT:HflL NAEEPQR <br /> W (3101997-3109 <br /> H <br /> Id, GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consirmhlal are fully and accurately described above 6,properehip ing nom.odd are classified,packed, <br /> U - marked,and labeled,and are in all resp«Is in proper condition for transport by highway according to opts icable international and nationo government regulations. <br /> II 1 am a large gvamiy generator,I certify that 1 have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically ' <br /> S practicable and that Kava selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and Future threat to human heal, <br /> and the eavbonmedl;OR,if I o a ..It quantity generator,1 haw made a good lairb eNort to minimize my waste generation and select Ike best waste management method rhos is <br /> « available 1.me and that I can afford. A <br /> Q <br /> } Printed/Typed Name Signature Month Day Year <br /> Z —tit_ OTT s '� vs ^ \..Cl.i' `.7✓� t/JV ¢:. .JC�_� IT s t.ti• J ti. <br /> W 1 17. Ta.m,poul.r 1 Acknowled emenl al e! t of Materials \ <br /> w A Printed/Typed NP t'ame - - {L 1 G yet 7r j Signature �/'/' Month Day Year <br /> LL 8 I8. Tram ler 2 A nowt rials <br /> R Pmnedt of Receipt of Mate <br /> Q Printed/Typed Name Signalure Month Day Year <br /> 1 <br /> W <br /> N <br /> U19, Discrepancy Indication Space f <br /> F <br /> Z <br /> — A <br /> C <br /> 1 <br /> L <br /> I 20. f«iii Owner a O roar Certification of racei t of hazardous materiels covered by this manifest except as noted in Ilam 19. , <br /> T Printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DISC 8022A (A/971 <br /> Yellow: GENERATOR RETAINS <br /> FPA 9700-22 <br />