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font Apprewd OMS No.2050-00391Ezpues 936961 See Instructions on back of r,qe 6. Npanmem or roxK Subommet Com", <br /> Plwe pmt or type. Font designed far an e%r(12yikh) her. SIXronmb,California <br /> UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifest Document N6.' 2. Page 1 Information in the shaded areas <br /> is nal required by Federal low. <br /> WASTE MANIFEST CAD 019151615141217131-71-11 � of 1 <br /> p 3. Gereroksa s Name and Mailing Address <br /> Nrat+ s ti.l:) <br /> h RV Cirmite' <br /> N 916 South Center Street, Stockton, CA 95206 Gene atop,tori <br /> An 4. Genemnar s Phase r <br /> '`YQYy 209 ) 546-9:.19 �j� 1 f • �� � <br /> S. Transporter 1 Compo y Nome 6. US EPA 10 Number Traropoom's ID t <br /> Ph <br /> 21 st Century TUC INIVID19181018191513 3 8 r', ass 702-575-2750 <br /> J 7. Transporter 2 Compmy Nome 8. US EPA ID Number Transporter's ID <br /> �U <br /> Da rtes Phone :- <br /> a Z 9. Designated Facility Name and Sib Address 10. US EPA ID Number Facility's ID <br /> +0� 21st Century aU <br /> 2095 ',Wlands Drive, East <br /> 60 <br /> e�u <br /> Z 11. U (including S DOT Description(includProper Shipping Name,Hazard Class,and ID Number) Centaltra 13. Total 14. Unit <br /> = IdNoo. Type OuutBy Wt/Vol I. Waste Number .. <br /> a'RQ, 1jaaxard_s m Waste Solid, N.O.S., 9, NA 3077, /^\ S'° n <br /> 3 PG 1n, :Debri) <br /> EPA/01h, <br /> G <br /> c E � . 1- D008- <br /> N Is. Stotc <br /> E <br /> � E EPA{pher <br /> TC. Stats <br /> O <br /> ae R EPA/Other <br /> f <br /> Z d. <br /> U <br /> ' nal Descriptions fa M <br /> n file M96-20 <br /> W <br /> K z <br /> J <br /> Z` <br /> O 15. Spedd Ilandig katntndiare and Add'ifioral Information <br /> Z Wear Protective clotUmj as required 24 Asa Braryency ?hcm: 800-648-9931 <br /> Wr, #171 %ticnal Response Center: 800-424-8802 <br /> X <br /> 16. 984ERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment aro fully and accurately described above by proper shipping more and aro classified, <br /> Upacked,marked,and labeled,and aro in all respects in proper condition for transport by highway according to applicable intenwSoml and national gowmmmM reguladom. <br /> If I am a large quareity generator, I certify that I have a program in place to reduce the wlume and toxicity of waste generated to the degree I have determined to be <br /> J <br /> G acommkally pracricabb aad that I haw selected the practicable method of treatment,storage,or disposal currently awilable to me which minimizes the present and future <br /> N threat to human health and the envirament;OR, R 1 am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best <br /> y wmb management method that is ossilable to me and that I can afford. <br /> o /Typed No Signature! / Momb DOX Year <br /> Al <br /> Z 17. Transporter 1 87 of Receipt of Materials <br /> kypd No <br /> Month Defy Year <br /> SW ' I-A Li 1011 1c)11 1 316 <br /> ty� 0 of R of <br /> TPra /Typed Name Signatures Month Day Year <br /> E <br /> 11yy E <br /> y0iarapomy Indication Space <br /> U F <br /> A <br /> Z c <br /> — f <br /> L <br /> I 20. FacilityOwner of Qnrater Certification of receipt of hazardous moterids oawrad by this manifM except as noted in ft.19. <br /> T -71 <br /> fhkead/Typed Noma SigmNre Moven Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS UNE. <br /> DISC S022A (1/95) Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br />