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TEXAS WATER COMMISSION <br /> M <br /> P.O. Box 13087, Capitol Station _ <br /> Austin, Texas 78711.3087 -t' <br /> Please print or type. (Form designed for use on elite (12 pitch)typewriter.) Form approved. OMB No. 2050-0039, expires 09.30-91 <br /> UNIFORM HAZARDOUS 1.Generator's US EPA ID No. Manifest 2. Page 1 Information in the shaded areas <br /> WASTE MANIFEST - - _ m <br /> Docuent No. of is not required by Federal law. <br /> 3.Generator's Name and Mailing Address A.State Manifest Document Number <br /> R.'.,. INC, 00255952 <br /> Qi6 S''U?H� CENTER STREET B.State Generator's ID <br /> STO:-I'TON, CA 95206 <br /> 4.Generator's Phone( 209 ) 4b" -4` 6? A T'.i' ii Cl TH <br /> 5.Transporter 1 Company Name 6. US EPA ID Number C.State Transporter's ID <br /> WEST: �;f ,' Ni 1 CA..- C,_. ...7 .E I 7 .q .;, .q .q D.Transporter's Phone (209)982-578 <br /> 7.Transporter 2 Company Name 6. US EPA ID Number E.State Transporter's ID <br /> F. Transporter's Phone <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number G.State Facility's ID <br /> ENCyCLE TEXAS, INC, -hail ;$ae <br /> 5500 UP P1VEQ ROAD Y' <br /> COPPtJi CFIRISTI . TX 79407 j .py) .11 .N '6 'f, (800)443-10 <br /> 44 <br /> ilk 11.US DOT Description (including Proper Shipping Name,Hazard Class, and ID tz.Containers offal UnnI. <br /> HM Number) No. Type Quant Wt, <br /> Waste No. <br /> X a'Pg NALARDOUS 7 WASTE =i't.IC. i,I.li t.it[)p4jTEC 941880 <br /> COPPER OF I DE <br /> G CO ) , 9, NA;0PC� r T I (F006 ERI" k 31 N P <br /> 006 <br /> t p �� <br /> E <br /> N b. <br /> E <br /> P <br /> A <br /> T <br /> 0 <br /> R 0. <br /> J.Additional Descriptions for Materials Listed Above K.Handling Codes for Wastes Listed Above <br /> Ila. CC 698-90 (PRECIPITATED RINSE WATER CONTAINi"iG <br /> METALS-LEAD,COPPER,ZINC) <br /> 15.Special Handlintq Instructions and Additional Information 41c�yF: °R1, 'EP p`rOT E':Tl�'E G).;THtNO, <br /> Ila. KEEP O-1 T i wATEHI. , '^.. <br /> F mlG 4-3ENC.V F.-h'INC rJ 7. r'a,I <br /> Felassilad. <br /> TOR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are <br /> d. packed. marked, and labeled. and are in all respects in proper condition for transport by highway according to appltcable international and national <br /> ent regulations,including applicable state regulations. <br /> large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br /> ically practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and <br /> reat to human health and the environment;OR.it I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select <br /> waste management method that is available to me and that I can afford. <br /> nature Month Day Year <br /> /Typed Name g On 1:,{'I'1 f o� r _ <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials Date <br /> R Printed/Typed Name Signature ,i .1 ( Month Da� Year <br /> V t }•.L <br /> N ( t ' �— - Date <br /> ement <br /> P <br /> 0 18.Transposer 2 Acknowledgof Receipt of Materials <br /> Month Day Year <br /> A Printed/Typed Name Signature <br /> E J <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> c <br /> L 20.Facility Owner or Operator:Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> 1 Date <br /> y e Signature <br /> nature Month Day Year <br /> Printed/Typed Nami <br /> While -orininal Pink-TSD Ficitity Yellow Tmnsponer Green-Generator's first copy <br />