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Sbte Or(flitorMa—Hsalth and Walbro AWncy Depirl moot Or IUaL'n Senmaf <br /> Toole Substances Cnnvni U.,S n <br /> Sara man;o,Uoro.+� <br /> r^.eaa•pont or tvp• farm poagnad ra u.w on Nna(17pncnl ryyewrner 1 <br /> U NIFORM HAZARDDU$ eneretora o. an.est opal norme:•nn.n ton snadnr..•,•,. <br /> 044002426 O«umemNc. <br /> WASTE MANIFEST of 1 (:eW <br /> i •• *rotors ame andMelling Address oto-ainfest D«ument umber <br /> II usLvm +Ia >amroLE (DPP n 4 57 2 8 71 <br /> P.O. BOX 6395 SZOC TON, CA 95206 Gte ^°r't°r'iD <br /> 4. 6ineretor's Phone 1 209 982-0600 <br /> ! r r cmpanme U AI Number late ranaporter'S I /" <br /> A (/�� –e <br /> �,. LG.II'�.G ✓..Z c-" ranspoTteT's none / l / k <br /> Transporter7. mpary Name S. US EPA ID Numbertate ranspater's ID <br /> rana,:L s horn <br /> asignatsd ac�. Name end is rasa U E AID Number tate suliryi 1 �. <br /> C /;1 r� f - l _�' v , .. A ; C A D 009452657 <br /> acilltya Phone <br /> /+ c7G / 415 324-1638 t <br /> 12.Containers 13. l4. <br /> 11.U$ DOT Description/Including Proper Slipping Name,Huard Class, and/D Number Total I <br /> Unit <br /> 1. <br /> No. T Quenu Waste No. <br /> E 1• ACEZONE SOLVESJP (FLM-ABLE LIQUID) #ON1993 1 jTr 4000 <br /> aI APPROX <br /> aI <br /> a ' r <br /> fir . b. <br /> OI <br /> • II <br /> a <br /> C. a <br /> COPY <br /> d. I <br /> i <br /> f) r: r_ C 7V 7sj. far histerisI& LISW Above, <br /> K,Handhng Coble for Wastes fisted Above i <br /> pjDtrEM W r�cT.PrRr�I-e.n37�C r (FIISBE)r <br /> Q4T�C N CAT 'E .�caaLER)r MEKP (I #01 <br /> • ! Z <br /> isl Handling instructions and Additional Information <br /> 'GLOVES, ODOGLES AND PFO=IVE CEDMINC (CAUfICN-FL M&%KZ) REFER 20 ATtAC7ID M.S.D.S. <br /> j1 <br /> :I hereby declare that the contantabeindw <br /> enl are ullyan 4 ratel as abed <br /> eborebyproperthipping name and are Classified,packed,marked,a in all res - i pr Per n lo for <br /> transport by highway according to applicable international and natil regula n . Date <br /> MonroDayPrinted/Tf9ed Name Si8 <br /> V! HOKIE A. POTIS <br /> T 1 17.Tran <br /> aporter 1 Acknowledgement of Receipt o1 Materiels _ Qite <br /> a 1-- NaINI�, Si -- Mpnrn ey Year <br /> ,i lit /I-/"t��. .n u— Q 17[l <br /> r <br /> e 18 Transporter Acknowledgement or Receipt of Materiels _ ( ____– <br /> ` T 1 Prmted/Typrd Name Signature i enrol Day I Year <br /> a <br /> 19.Discrepancy Indiwuon Space <br /> t a1 <br /> CI <br /> 1 y <br /> L <br /> T �20.1pminy Owner or Operator. Certification of recelpt of hazardous materials covered by t Is manifest except as noted m <br /> r ta <br /> Ptd/-Typed me ignat Menrli—baY Yeer <br /> T /\.j IT-Z <br /> L ArI <br /> i While: TSDFSENDS THIS COPY T DOHS WITHIN 30 Di YS J <br /> psis e:av n r//ea) r, c �+.•r'�r'�'� <br /> 3000, Sper roto, CA 9..E1O <br /> ,F.nF E::.S..^� �..•—•rw+i�••�wn.oe.,q.r�..,-. .,. --,..••�..-r.+s.^,v.!..••.+�..r.--+-•- <br />