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ro,end MB Ni 2050-0l Praledpl,.,goncy <br /> roved OMB No.2050.00]9 Ex ci,9d099 See Instructions on back of a ' <br /> pri I P r 1 poo Deparlmanl of mml.Substances Cannel <br /> print or type. Farm designed krvse on ehm(ISpilch!typewilfer. "� Socromenlo,Californiaollfr <br /> UNIFORM HAZARDOUS 1. Ceramist's US EPA ID No. Manifest Document No. 2. Page I I Information in the shaded areas .i <br /> WASTE MANIFEST C p 9 8 1 4 4 7 0 1 SI 1 117 1 111 1 of 2 is not required by Federal low. <br /> A. Stalc Manifest Document Numher�° s <br /> SiteAddress 24797750; <br /> P.O. HOX 830 ,J - 12101 E. BRANDT RD. <br /> p IsOCIQ''FORD CA 952.Y7 LOCKEFORD B Stole Generaloi s 10 <br /> n 4. Generator+Ph...1 209-727-5504 X 36 CA 95237 <br /> _ d. US EPA ID Number C Stole Tmnsporler's 10[Rnseaed.l .0539 <br /> ss S. Tramparlar 1 Company Name <br /> rD <br /> o North' State' Envi=Onmental CAR 0 0 0 115 9 4 5 9 D. Tronsporler+Phone(650)588-2838. <br /> 0 <br /> aF 7. Transporter 2 Company Nome B. US EPA ID Number E. Slate Transp.,Nr'a ID[Rese"od,] <br /> iQ Rust and l cans Trucking -CAL 0 0 0 2 0 3 4 4 4 F. Transpari.ra Phone 443 6193 <br /> - <br /> .0 -9. Designated FcEillty Nome and Site Address .10. US.EPA ID Number G. 51.m Facility'.ID <br /> Chemical Waste Management, Inc. C A T 0101 0. 6 9 6 1 1 71 1 <br /> +z 35251. Old Skyline 93239 H. fadlhtr's Phan. <br /> .O Kettleman Ci�t]]'r - C A T 0 0 0 6 4 6 1 1 7 (800)222-2964 <br /> )Q . <br /> llJ1 <br /> -11. U8 DOT Dnrrlption(including Proper Shipping Name,Hazard Class,and ID 12. C..Woer+ 11 TololId. unit Number] No. Type Ouanli WI/Vol 1. Wmta.Numher <br /> a' ' NA3077, HAZARDOUS WASTE SS SOLID,N.O.S. , 51"'172t (ARSENIC,LEAD) , 9, PGIII, RQ`D064) - ' ,7 DF 1750 P <br /> 3 G EPA/016' <br /> r E <br /> 00 N 6' NON RCRA HAZARDOUS WASTE SOLID 51.1'352 <br /> m E (PAINT SOLIDS,OVERSPRAY) - - - 3 BA'. 4790 P <br /> R - - PPA/Other <br /> v A <br /> ma T ` NON RCRA HAZARDOUS WASTE SOLID - Stdy52 <br /> O . ,(PAINT SOLIDS,OVERSPRAY) 1 DF 75 P EPA/other <br /> R <br /> as NON RCRA HAZARDOUS WASTE SOLID - 51ete223 <br /> V (OIL, ABSORBENT) - 1 DF - 300 P EPA/o,h.r <br /> w <br /> Z J. AddlBpnol Dmcriptiom far:M*Kal,Wind Abovu eD.r CO .'Handling Cndm For Wastes Listed Above <br /> a- .':D <br /> A:=6755 ,�, ADD EPA CODES 30007, DOOR 171 4 a. h. <br /> W <br /> � H: EB8744 , NAM <br /> Q C:.£138744 <br /> Q1 .5 riling Inslmclivns'and Addilionol Information zmargellay <br /> t= STEVE WAREING 209-727-5504 X36 <br /> Za+ <br /> w Trane 1 address: 815 DDRO(2OE Ave. as., SO. SAN FRANCISCO, CA94060 <br /> ti Traci 2 address: 15353 01d By 80, 311 Cajcn, CA 92021 d: <br /> y 16. GENERATOR'S CERTIFICATION: I ham6ydmImms thus the eanlwla eFlhB comfynmenlon fully and aemmisly described above by pmpwAlpping name and we eloulhad,pec4.d, <br /> VQ mashed,and labeled,ordure In all romped-in proper condition for transport q highway awarding to opplleoble international and nalionol government regulations. <br /> If I am o large quantity gonsrotur,I tmslfy that I'has.a program to place to reduce the vel ma and toxicity of wool.Elmorvled to the degree I have determined m 6e emnomimlly <br /> ff prodico6le and that I h w salaried the pradico6la method of Ireahnanh+tomga,or disposal currently available W ma which minimizes the present and tutor Ihreol b Aumon health <br /> and the environment;OR,if I am o small quantity goneralor,I have made o geed Falk ellod to minimize my wasle generation and select the beal waste management method that Is <br /> 0 available is me.and that I con afford. <br /> y hinled(',7�ped NF �� r, � Signatures / InnBU°rf Year, <br /> �w f - <br /> K� .. <br /> C0 T 17. Tron+ xxr%,l Ackeowlal emend of itecel l of Mosolels <br /> w Pdnled/T ad Name I - - gr Year <br /> Oe 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> T Pdamd/Typ ei Nama - - - SlgnaNre - 'Mcolh Day Year <br /> RE <br /> .rWis <br /> Q <br /> U 19. Discrepancylndicollan Space - - - <br /> Z P _ .. <br /> C. - <br /> I <br /> [;r <br /> 0FodliOwneror lw Cerli8co8on of mcei 1 of hazordam materials covarad 6 Ibis manifest eze t as noted in Item 19. <br /> T inted/Typed Noma SlgnvNro <br /> Y Meath 'Day Yew <br /> DO NOT WRITE BELOW.THIS LINE. <br /> DISC B022A f1/991 <br /> EPA 8700-22 - - Yellow: GENERATOR RETAINS <br />