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.State of Ca nia—Environmental Protection Agsncy Form Approved OMB No,2050-00�-9.fExpir>rs9 30-99) See Instructions on back a ]ge 6. Department of Toxic Substances Control Please print or type. Form rfesijlhed for use on elite(12pitch)ty`p'ewriter. Sacramento,California Y. Gener tot's US EPA ID No. Manifest Document No 2. Page 1 Information in the shaded areas a U QOM HAZARDOUS Y t:+ - ASTE MANIFEST ''�' `t is not required by Federal law. ` ' C 'A9813698844 2 8 7 1 1 Z 3. Generator's Name and Mailing Address State Manifest Document Number LODI METAL TF" 98290'(r72 PO BOX 967 WDI,CGA 95241 : Enr erataS ID — o State 1 In 4. Generator's Phone ( 209 ) 334-2500 ry 5. Transporter 1 Com any Name 6. US EPA ID Number State Transporter's ID IM ORT & G+atVil+Efo Transporter's Phone (9+6) y. —23`2 —� O '7+�ca�r 1�s'a f J/6 `Y6 7. Transporter 2 Company Name 6. US EPA ID Number i% ,5fate.Trcrosporter's 15 Q '7ransporter's Phone 11 NU 9. Designated Facility Name and Site Ass ddre10. US EPA ID Number State facility's ID - MtGRM Z V OTL,►W. I `. FnctliN's Phone � 0 I, Ch 94560 ya) 12. Containers 13. Total 14. Unit , ,U 11. S DOT Description(including Proper Shipping Nome,Hazard Class,and ID Number) No. Type Quantity Wt/V este Number — com_ T RCRA RLZARMJ3 WASTE LIQUD . 221-`i! 3 s� V/ .r o 1 T "' k/Other N E -- - —^! Stat» o N mm E ' R ' C' A ------ O T State �I 00 O ()CT 121%9 PA/otf.r R Z d LODI' METAL TECH. State - - LU EPAfOther U LU -__--. _.. .- --.._.. _ -- -- - - - - - --._.._.. N 1. Additional DeScripti�.ns for Materials Listed.Above . -� , -- K. Handfirig 4odec fair V4cisie5 fisted A1ml _ „.A. 171 rn ►� ll(s�� . ��3 w Z15 Special Handling Instructions and Additional Inr fomation a %AR GEDVM & PROTPX,`!"M C10 HLA110- SITRt 213 KEUY ST. Z 24 HR. MM. # (209) 369-4683 v Tall). CA w 16 GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, Q marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. U J+ If I am o 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 economical iy a procticable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health N and the environment;OR,if I am a small quantity generator,I have made p good faith effort to minimize my waste generation and select the best waste management method that is ne available to me and that I can afford OPrinted/T ped Name Signa Month Day Year Z -:' 0 1 9 2 9 9 w T 17. Tr -porter 1 Acknowled ement of Recei t of Materials LU R Month Da Year K p Print. Typed Signatur r..` Y NS c r 0 9 ,— 9 9 f P w 0 18. Transporter 2 Acknowledgement of Receipt of Materials 0 T Printed/Typed Name Signature Month Day Year LU E R _ V 19. Discrepancy Indication Space 1/ oy�e,�.�-� 9r 1,1- LOCA (C 1<6 -4 � Z F eIll- rlcn . v q-�9- Ci' RfTvv-" d o r/'+�,srcir-Ter. A _ t J,in'. yPed �,Owner or eroto r i kation of ei t of hazardous materials covered b this man' st ex as noted in Item 1T Na Signature - Month Day Y VLee DO NOT W ELOW THIS LINE. Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. 22A (4/97) (Generators who submit hazardous waste for transport out-of-state, DTSC 80 EPA 87022A produce completed copy of this copy and send to DTSC within 30 days.)