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• '1 State of California—Environmental Protection Age/(y/ <br /> If. Form Approved OMB No.2050- xpires 9.30-94) See I11ions on back of page 6. Departmen <br /> Please print or type. Form desi r use on elite(12-pitch)typewriter. So <br /> UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifest Documen=A1 <br /> ge 1 Information <br /> is not requir <br /> WASTE MANIFEST A D 0 6 8 1113 2 3 8 7 116 1 l <br /> 3. Generator'�' r �aa d il'n Ad re an <br /> any A„State Naprest Document ber <br /> o <br /> Ef uEe <br /> 8830 West Linne Idoad, Tracy, Cts 5.1537E <br /> t\ B,"$fate Generator's ID <br /> N 4. Generator's Phone ( C � <br /> to 209 836-096 Steve Barton - <br /> Cj 5. Transporter 1 Company Name 6. US EPA ID Number C.Stage Transporters <br /> C9 DECON Envirommnetal Services <br /> CAD 9 $ 2 4 6 t3 1 8 D. Transporte's Phone <br /> 73 <br /> 7. Transporter 2 Company Name 8. US EPA ID Number E:5tafe Tror"nsporter s ID <br /> U Crosby & Overton CAD 0 2 8 4101 91 1 9 F.,Tlanspotf t�Phong� <br /> ®Q 9. Desi nate m S' 10. US EPA ID Number Q. St Facil'- s ID <br /> g t� tt5bn <br /> A. <br /> N o 1630 West 17t1i Street, Long Beach,CA 90813 �- <br /> u H. Facility's Phone <br /> AlDI 01 21 81 410111 91 01 1 9 .': 0_4342-5, <br /> 3+2-5, <br /> ( U 12. Containers 13 Total 14. Unit <br /> Z 1 1. US DOT Description(including Proper Shipping Name,Hazard Class,and iD NumbedNo. T e Quantity Wt/Vol I <br /> IUDH� NON-RCRA Hazardous Waste Solid <br /> 3 (Detergent pH- 7-8) 1 8 M sty P <br /> I c�i E <br /> 00 N b. <br /> 00 E <br /> N R <br /> A <br /> o T C. <br /> 00 O <br /> LU <br /> R <br /> LU <br /> Z <br /> d. <br /> LU <br /> t U <br /> w <br /> N <br /> Z ,Addifi�otyat DeSefµ�ttorFs for Rioters Toted A�aMc i K,'Nandhog,Godes for Wastes Usted hbo <br /> O " � <br /> t � �� :•' v" e �' � � k � g'v s yi � C d <br /> Uj <br /> � a <br /> O 15. Special Handling Instructions and Additional Information <br /> w <br /> 2 <br /> F- <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name <br /> packed,marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national gover <br /> F U <br /> IJ If I am a 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 ha <br /> economically practicable and that I have selected the practicable method of treatment, storage,or disposal currently available to me which minimizes the <br /> fr a threat to human health and the environment; OR, if I am a small quantity generator, 1 have made a good faith effort to minimize my waste generatior <br /> N waste management method that is available to me and that I can afford. <br /> 0 Printed/T 4 e y Signature <br /> /p� 7 l/� _ D Month <br /> el" <br /> t <br /> Z TR 17. Transporter 1 Acknowled ement of Receipt of Materials <br /> LU A p•��,�,�,ted/Typ`ed me/� ` ` Sign re Monti <br /> LU . <br /> 0 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> LU T Printed/Typed Name Signa re Montt <br /> LL E <br /> O R <br /> I LU 19. Discrepancy Indication Space <br /> UF <br /> A <br /> Z I <br /> L <br /> 1 20. Facility Owner or Operator Certification of recei t of hazardous materials covered b this manifest except as noted in Item 19. <br /> • T Printed/Typed Name Signature Month <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> I <br /> I <br /> DTSC 8022A (9/93) Yellow: GE^ <br /> EPA 8700-22 --- <br />