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Form 4pprowd OMB No.2050-Wa9(Espir..9-30-9e) See Instructions on back oi`ae 6. o.parm,.,n ase ra.,r s.b.,an�e.can <br /> Please prim or type. Ferrer despised for use on,fife/12pikh)"ime m.. Sacrom.nro,California <br /> UNIFORM HAZARDOUS 1. Ganwotoe,U3 EPA ID No. Momfics Doasment No. 2. Page 1 Information in be rhoded areas <br /> / is not required by Federal law. <br /> WASTE MANIFEST Can 019151615141217131-11-17 ase 1 <br /> 3. Generator's None aed Mailing Address _ <br /> 'ti M��fi7 �JJ 1 i r ion i I <br /> mr Circuits { f <br /> 91 u South Center Street, Stoi=ktcn, CA 95206 <br /> m A. G'"""°e'P"°"'209 ) 546-9219 <br /> S. Trump.~1 Company Nome 6. US EPA ID Numbw <br /> m <br /> 21st Century r yVD980895 33 8 <br /> J <br /> Foh7U� <br /> I. Trongnarfw 2 Cempary Name S. US EPA ID Number Sizes- <br /> 41 U <br /> i Z 9. Designated Facility Nmne end Site Address 10. US EPA ID Numbor - 'Skahs- <br /> °C 21st Century EM a _ <br /> S2095 Newlands Drive, Fast <br /> 7� ripi'm1py Ny F39408 41 if <br /> D Z 11. US DOT Description(inclo lig ProperShipping Nome,Hamid Clens,and ID Number) 72. Comatrnen 13. Taos la. Unit <br /> No. Tvass Oumnity YIt/Vol este <br /> a , f=n^"+'�„a Waste Solid, PT.0.5., 91 NA 3077, sba <br /> 3 G PC III, :Debrii !� EPA/one <br /> E <br /> T C f _t700A <br /> N b. Slate . <br /> HE EPA/once, <br /> r R <br /> A intron - <br /> m T ` <br /> R <br /> W — <br /> Z d. e <br /> W ' <br /> U EPA/0 <br /> IN <br /> Z .....IttldAbow <br /> O 15. Spend Handling instrinsfices and Additional Information <br /> < Wear Protective clothing as rPuui-,aci 24 Flo= Mnergenal Pte: 300-648-9931 <br /> WrZ{C. #171 National Restxnse Center: 800-424-8802 <br /> I- <br /> 16. GENERATOR'S CERTIFKATION: I hereby declare that the comment of bis consignment am fully and accurately described abow by proper shipping name and are classified, <br /> packd,marked,and labeled,and ons in an respects in proper condition far transport by highway according m applicable international and national gowmment regulations. <br /> V <br /> If I am a large quantify generator, I certify that I haw a program in plata b reduce be wlume and toxicity of waste generated m the d gree I haw determined to be <br /> G wonomically practicable and that I haw selected the practicable method of treatment.memos,or disposal currently awiloble to me which minimizes the present and firm e <br /> N throat to human health and the emirar;rwrn;OR. if I am a entail quantity gerearaisr. I bow made a good faith effort b minimize my wmhe generation and select the best <br /> tY wast;morsigmemet matfred that b awiobk to me and that I can afford. <br /> O Prinnnted/Typed Name Signator / Month Day Ymw <br /> Z 1 17. T 1 A of R of Materials I <br /> w Typed None I S aasn�� /1 i i Manlh DW Yea <br /> F = XSr j I r ✓ C ' <br /> W 0 18. T r2A d oft <br /> sL i Pnntd/Typed Name Signahme Abmh Day Year <br /> O i !,t <br /> y 19. Oiscrapancy Indication Spasm <br /> F <br /> U A <br /> Z C <br /> I <br /> L <br /> I 20. Fau Owner or Oowator Certification of rami of hamrdous materials covered b Mu manifest en m noted he Nem 19. <br /> T Pr:rbdRYfsed Name SigmNro Month Day Year <br /> r <br /> DO NOT WRITE BELOW THIS LINE. <br /> 0750 8022A (1/95) Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br />