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mental Protection Agency <br /> OMB No.2050-W39(Expires 93094) See Instructions on bacT 6. Department of To.ic Svbsmnces Com,ol <br /> or type. Form use designed for on elite(12p�,pew„rer. <br /> .^ a Sa<.amemo,Calilornio <br /> e' LIdIFORM HAZARDOUS Generator s US EPA ID No. Manifest Document No. 2. Page 7 nformation in Me d1ow. <br /> 4 WASTE MANIFEST ' is not required by-r- L ^ aa01 , ; <br /> 3. Generator's Name and Mailing Addreuq. State Manifest Document Nutmr��berr� {�QC' 't C C LEASa , CoPt . 2 OfIiGI ' , t�1137 S. SToCKTON ST, STGC;TU4r CA 8.State Conerator's ID4. Geerator's Phorse•(: r( a p 5. Transporter 1 Company Nome 6. US EPA ID Number C. Stab Tmnsporter's ID09 1'/�4 <br /> ALLIED PETRGLtUI i C A S 'ti u O 5 7 i D. Tronsponeri Pho e(ZG9) 57E-L5G <br /> J 7. Transporter 2 Company Name S. US EPA ID Number <br /> UE.Stare Transporter's ID <br /> F. imnsporler's.Phone a .�•z=•:;. <br /> Q 9. s' note Foci' N <br /> Z D9 Igr d I„Y gme,prid Si!e_Address 10. US EPA ID Number G.,5tvte Focdey4.ID <br /> �� ttiEF-il}Jt:7.J JL-r,VJ.Ixt <br /> O0 13731 N H4'Y 33 CAD ` 8 3 & £ Z 2 is <br /> tc ,t tY1:.;Foc l}ys Phone,_ <br /> »v PAITr.?,Su:., 0A A D ^ p 3 ' S ' 7 d {BGGj 874-4444 <br /> J7 Z 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Containers 13. Total 14 Un t <br /> N No. T Ouara' WI/Vol 1.-Waste Number <br /> ti <br /> a Stab <br /> 3 <br /> `— MOt, RCRA HAZARDOUS I,ASTE LI,r:UID NILS NA 910"+” 223 <br /> n N E /7 ( T T /) 7 EPA/Other <br /> co N b. V !/ <br /> VM E St a e <br /> dA EPA/Other <br /> W T C. <br /> 0 Stare <br /> W R EPA/Other <br /> CA <br /> LL Stop <br /> U <br /> W EPA/Other <br /> N <br /> Z ] Addni.nal Descripfkma for Marerivls.Listed Above K. Handling Codes for Wastes Listed Above <br /> O <br /> w 951ATER A?4G F9It}SATE b. <br /> a C. a:. <br /> Z <br /> Q 15. Spec of Handling Insnvction:and Addltlonol Informafio <br /> Tc- -,E <br /> Z Fk S_rtttalEL - _TY _ i r_I1. .i.?T".CT - ('4I1 ) <br /> k.tth <br /> NERATOR'S CERTIFICATION: I hereby declare that the contents of the consignment ore fully and accurately described above by proper shipping name and are classified, <br /> Q cked,marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable federal,stale and international laws. <br /> U <br /> tl <br /> am a large quantify generator, I certify that I have a program in Alam to reduce the volume and toxiciy of waste generated to the degree I have determined to be <br /> a nomically predicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future <br /> sn at to human health and the environment;OR, if I am a small quantity generator, I have mode a good faith effort to minimize my wash generation and select the best <br /> waste mdna emanf method that is available to me and that I can vHord, i <br /> Q Typed Name ` <br /> } 1 SignaNre' Mo Day Yea�rZ • ns oder 7 Acknowled ement rot Recei 1 of MaterialsRa Type ante r J Signatu / Doy �'/YeaLO s orter 2 Acknowled emenf oTyped Name SignaNre Month Day Ye or I <br /> Q R <br /> All 19. Discrepancy Indication Space <br /> N <br /> U A <br /> Z CI t <br /> E r <br /> I20. ed/T Owner or Operator Certification of receipt of hazardous <br /> T Pri�d/Tmaterials covered lois m <br /> thanifest exce f as noted in Item 19. i <br /> yped Name <br /> Y Sigma Nre _ <br /> s� IJ N t 1 1 s, ( ) 1) Month Da t Year <br /> DO NOT WRITE BELOW THIS LINE. `- <br /> DT5C 8022A (7/92) i <br /> EPA 8700-22 <br /> Green: HAULER RETAINS <br />