|
,16nalo—E.Imnmen1a1 Proiecltan Agency
<br /> roved OMB No.2050-00391Ezplres 9-30-991 _, See Instructions on back of pug•. of Tolle Substances Control
<br /> :Inl or ype. Form designed for use on elite(12-pach)typewriter. '. Department a te
<br /> 'Socromenfa,C°IlFornl°
<br /> UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifeal Document No. 2, Page 1Inlommlion in the shaded Dram
<br /> WASTE MANIFEST D 9 8 1 4 4 7 0 5 9 8 5 1 2 .is not requireelly.Federal low.
<br /> of
<br /> 3S sIsffi ailgd ngl yS Site Address A, Sime Mmifeal Document Number 94798
<br /> ' q �,y�a q
<br /> LOCKEFORD 3p CA 95237 12101 E. BRANDY RD. LdF YQ 1
<br /> o LOCKEFORD B. Slat.Generator's 10
<br /> nA. Generators Phan,I 20Q-727-5504. X 36 CA 95237
<br /> h5. Tronaporier 1 Company Name 6. US EPA 10 Number C Slate Tmesp irlers ID lReous,ned.1 .65 9
<br /> m North State Environmental C A R 0 0 0 1 5 9 4 5
<br /> o D. Tmperhrl Phone
<br /> 0
<br /> m 7. Trom arNr 2 Company Nom, E Stale Treaspadars ID.Reurved]
<br /> P P Y 8. A EPA 10 Number
<br /> {J Rust and Sona Trucking CAL 0 0 0 2 0 3 4 4 4 +, ,
<br /> )Q F. TmneporNra Pha'ne
<br /> V 9. Duignoted FaciliM Namo and Site Address 10. US EPA 10 Number G. Siete Fhcllity's ID
<br /> )a Chemical Waste Management, Inc.
<br /> z 352517, Old S15 line R��td t
<br /> )� Kettleman C3yty 093239 CAT 0 0 0 6 4 6 1 1 H. Facility'.P
<br /> O !IMO)222-2964
<br /> l'a
<br /> 11. US DOT Description mdudin Pro Proper Shipping Name,Hazard Class,and ID Number 12. Conlniners ,13. Total 14. Unit A
<br /> VI• g P PP 0 I N
<br /> j M .
<br /> T e Ouanli WI/Vol I.Wash Number
<br /> z °' NA3077, HAZARDOUS YD\3TE,90LID,N.O.S. , ` Slole172
<br /> _ (ARSENIC,LEAD) , 9, PGIII, RQ(D004) 7 OF • 1400 p
<br /> 3 G EPA/Other t
<br /> E Doo4
<br /> o N b, NON RCRA HAZARDOUS WASTE SOLID Sm1e352
<br /> m E (PAINT SOLIDS,OVERSPRAY) 3 BA 3700 P
<br /> -4 R EPA/011e,
<br /> e A HAM
<br /> o T C.
<br /> NON RCRA HAZARDOUS WASTE SOLID 51-10273,
<br /> m 0 (OIL, ABSORBENT) 3 DF 750 P
<br /> R HA/OIFe , 'i
<br /> z
<br /> d. NON RCRA HAZARDOUS WASTE SOLID51-10223
<br /> w (OIL, ABSORBENT) yq DM
<br /> U esti. •GI;V V. P FRA/OlhOr
<br /> u
<br /> I NRH
<br /> z 1, Additional Desclpilam Far Materials listed Above ter' -°O K. Handling Codes for Wasln Usted Above 1
<br /> O at: EB6755 , ADD SPA CODER D007, 13008 171 a. ' b. v: '
<br /> w b:EB8744 HAM ,
<br /> m c: EB8743 NAM c. d
<br /> Q ,
<br /> 0 I5. Sp,dol Handling Inalrudions end Addilivnvl Inkrmallon
<br /> STEVE WAREING 209-727-5504 X36
<br /> a �
<br /> z Trane 1 address: 815 DUBUQUE AVE. -Be, SO. SAN FRANCISCO, CA 94080 a; a r b; .)%1(*-Ii-
<br /> 3:
<br /> -Z Trane 2 address: 15353 Old By 80, El Cajon, CA 92021 C: C�
<br /> H
<br /> Q16. GENERATOR'S CERTIFICATION: Thereby dad°re that lha mnlenls of this c°mlgnmont o1-fully and aceumlely dmcrlhad above by proper shipping nam°andora classified,packed,
<br /> V marked,and labeled,and ora in all nspacb In proper condition for transport y highway according to applica6le international and nations Pgwa summl regulagam.
<br /> IF I am a large quanliy generator,I palls that I hwe a pragrom In place to reduce the volume and Imiciy, f wails generated to the dnme I have determined na be scooter it
<br /> a prodicable and Thal I lava saleded ih0 raclic.bl.method el Irealmenl,alar° inhuman
<br /> y 1
<br /> h P ge,a,disposal c.ranlly avnilo w to mo which minimizes Ila present and future gems to method health
<br /> and Ila envimnmanl; at I tF I o1-o sma 1 quvnliy gonerotor,1 have mode°good Faith a8ar1 to minlm(xo my waste gonerallan and select the best vraslo management method that is
<br /> O
<br /> available t°me and Ihol can aflard. i
<br /> > Printed/7 ped Nama �1 // Si nam(° /"
<br /> v G'. 1�.J+`l��)CAAIE:% g '^i, ,.!�l�i'`.r!A�yr"''='� L 1 h_ -f(1
<br /> z
<br /> 1L T 17. Trans der l Acknawled amenI of Receipt oI Materials c..,
<br /> V
<br /> Priale"ed-mom. i "31
<br /> h . 77Do '^Ye)ar
<br /> 0 IB. Trans ortar 2 Acknowledruse.m of Rocai 1 of Materials
<br /> O 1 Prinled/Typed Name E Signature Mvnlh Day Year
<br /> N
<br /> a 8
<br /> V 19. Discrepancy Indication Space '
<br /> i
<br /> Z F
<br /> _ A
<br /> C
<br /> L
<br /> 20. Facili Clwner or Operator CedlHcalta t aF meal 1 of hozardvm materials covered this mon(last me 1 as noted In Isom 19.
<br /> T Printed/Typed Name Signator. Month Day year
<br /> Y
<br /> DO NOT WRITE BELOW THIS LINE.
<br /> DISC 8022A(1/991
<br /> EPA 8700-22 Yellow: GENERATOR RETAINS
<br />
|