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i <br /> State of rove rnie B No.2 and Welfare 039(Expires <br /> Department of Health Services <br /> Form Atiroved OMB No.2050—OOJ9(Expires 9-3r` Toxic Substances Control Division <br /> Please prigt or type. (Form designed for s on pitch tytyle: Sacramento,California <br /> - UN FARM'-HAZARDOUS -T' Generator's US EPA ID No. Manifest 2. Paget Information in the shaded areae <br /> WASTE MANIFEST t L A I) `f L! t+ J !} `a PPm of It is not required by Federal law. <br /> 3. Generator's <br /> neretois eme and Mapl Ndteps l_ L n f� A. State Manifest <br /> ,vibe x c fJ) r /, <br /> ''9.50 (lvUv37F l/3 L- pA 1 V� <br /> 5 t7!4rt f Pili/ E/a. is A a 13. State aenneerator'e ID <br /> o a. Generator's Phone(,"t0 9) CT S,' ?� �� �,G,Pj G f !z' ��I / <br /> pj 5. Transporter 1 Company Name e. US EPA ID Number C. State Transporters <br /> L'A f C)C 5 C W T y:VG l• /NJ(. (/V G, L .fa n CJ U q Ll G 4 3 `s D. Trenaportar's Phone / x.^ <br /> N <br /> s�� 3S—f35.3 <br /> m 7. Transporter 2 Company Name a. US EPA ID Number E. State Tranaporter's ID <br /> g F. Transpoder's Phone <br /> op 9. Designated Facility Nem.and Site Address 10. US EPA ID Number G. State Facility's ID <br /> �Oca �S> /hf:A 1ilVQ <br /> H. Facility's Phone - - <br /> <OZ i; I < N7anir� C /+ 9yro+ ,ggcaaf4b /r59 �/iS= 335=/353 <br /> N¢O 12. Containers 13. Total fa. I. <br /> ik 11. US DOT Description(Including Proper Shipping Nem,,Hazard Class,and ID Number) Quantity Unit Wale No. <br /> J No. Type <br /> goo a. W A5 1 L' 6: " _ 4'n'.4 C Wt/vol .., <br /> = States/ Z <br /> F: E �. L� l'(_ Q <br /> oo _ <br /> 3 N U d 1 � U (J O 1,? EPS OIO eP(/C <br /> E b. <br /> N R State <br /> S A <br /> OP T - EPA/Other <br /> N O <br /> Y R <br /> C.$ Siete <br /> m <br /> EPA/Other <br /> 1- tl' State <br /> Z <br /> W <br /> U EPA/Other <br /> w <br /> 0 J. Additional Descriptions for Mete isle Listed Aaova <br /> Z - K. Handling Codes for Weaea Listed Above <br /> Z ta'ii 5 T c- t= <br />