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State of C ',,fornio--$nviranmeM01 FrateZdan Agariq See Instructions on back of Q4;0, Dopartmenl of Toxic$vhstancas Control'„•' <br /> FofM Appraved•OMB 2060-003v,(Expir*s 9-30.99) Seeromonro,Califpmio '" <br /> piwsu print ar type. Fa aligned For use on&fire(12-pltch)typewriter. �''•• " <br /> 1, Genemtar's U5 EPA ID No. Manifest Documanl No, 2, Page IInformalion in the shaded <br /> UNIFORM HAZ`WOUS ib not-9u;rod by F"ral',Io-«" <br /> WASTE MANIFEST. v. of r <br /> `c• S._� ' „ '=t .. isA.:$tole JA'aXife.trD'eivrri► 'Wutnbp'f, ,,t� •„�t;, <br /> 3, Geperolor's Name and niFiO��N)s �- h <br /> r:. <br /> r;a b <br /> 1 C. <br /> LO a. Grmeretor's Phone( '?tt i h;,,y"A 4S?^.-jY}Tl'A�i <br /> ti <br /> 04 5. YransperterI Compony Nme 6 6. US EPA ID Number C,'Slate iransporter'0D <br /> A t <br /> t <br /> Mm <br /> 7. Transporter orter 2 CoCom pony ame NS. US EPA ID Number E.'Sratq Trmra¢4elar''�Ib' y;'i ri •F4 t"'}1•�:°�;•'•y'- <br /> W <br /> PJ hP1HPar1dF"7 P,ho”. <br /> Tel <br /> pnabd Foe hl Ay'•�lJegd ' d' 10, US EPA ID Number G:,5ta1e', d )t ti P <br /> � �• _�?64 �, .a f��.Ix'r,tl'tl.'�' '•�:1'� 9''';"" � r' ,r;G„ <br /> N',�;Fhcility's/13hone <br /> A 12. Containers 13. Total X14, Unit <br /> --7-7— <br /> US DOTbeerlroClass,and Ib NuhrWI/Vol <br /> pNType Quantity <br /> Z <br /> • �1 Y.L"'Y+ %v S.�Ps�l.i:'ty�'J 'li,•.'.,l�i� :I� '.� ,l%:A'''`�:':;'� 4�'+�• <br /> _2 ,. .���, •:� i�tiCtt ;�dt;yfr4i'q '�.;;: ',i,_:.i:: .� 1 ,�• , ,�'I , // '•�. ''t�6r �.j� ,r+.,,.,� , <br /> I. ' ` i'" ,�' .,T..�,' �) j' ^ �' / •,, (,' IYl'�l:f�'a%�',.I,1,.•,f'• 1^,, <br /> CfL.F?tit�i 2Y'14 i^i. 'i•\+#:,'•.;.% 'U.1, ,.rl .ii. 'i r':, f ,r; <br /> N E 6^ .Slate ;,1,6•',• .0•, R� <br /> o; N <br /> IG',.' <br /> ` �• 'D(: 'EEA'lt�f!G��,h,'i�"!x,47' <br /> c , <br /> wK. Handling Cade,fen Wastett Llsbd(lboYe tt <br /> N 1;Addi6ondl'Do�t�rjo "r y <br /> Z �'( My"fq" 9wf <br /> " at,%4" t t <br /> ` �f� ; mY ✓rJi`('i'Yn.'t.��k.�'; n. , 1 ';' ';t8;'titi�•;7,��tii'; i <br /> C', n7,C;j{?';,r97v., �,/•�, k' ^,/ rr°' i <br /> � '',i�t�, n"' I^,;1�: ,r:,�r;(:S "S't y',t/,� ;'i':'(v w „�,•i,'� � ,,� 'o• ,� d.� <br /> i "oYn <br /> 1." .,c._, 7 <br /> ., -4. i1 I <br /> ,e <br /> tSF? 9Z. <br /> 1ty"r;fN�iY <br /> Pi <br /> ` — <br /> � <br /> 16.,GRNERATOR'S �RTlF1r/gtoN: 16reby dedor■that the contents of this c,ndgnmenr oro fully and oecarately described abevo by proper shippi:p nv,�o pr s o:,•�, <br /> "norked,and Iabo6 drtd are in all respects In proper condition for tronspprt by heir, y according to applieoble international and oat anal go.emmeM regulations. <br /> a If I am a Iarge goaM1I�t3enerator,I c&mlfy that I have a p ram in place to reduce the volume and toxicity of waste generated to the degree I have determined ro be eeohoetiaaFly '� } <br /> 1 a predicable end Ihvt tihwa selected the roc!"ble mtlhod of treatment,storoge,ar 44pesal curronlly available to me which minimizes the prowM and future Ihrom to human health <br /> and the onvironmenY OR,1F I am a small quantity generator,I hove made a good loirh agart to miniatlze my waste generation and salad the 6611 waste monagemem mil trot is" 'y <br /> tz available to me and that I can afford. <br /> O Signature l,yont�t' �ay Y f. <br /> I' y Printed/Typ"ed/Name <br /> 1 T 17. Transporter I Aekni,:vl sit of Receipt of Materials i ni t h i <br /> N PrintedfTypa '� �X r <br /> J, <br /> P •' <br /> 'o 18. Trans ort.r 2 AeltlrCwled : r f Recalls)of M Is Month Day i,o <br /> �t O i Prh+t6d/Typed Name Signaturo <br /> N cW E �. <br /> {41'• U 19. Discrepondy'I%dicc ibn,Sp0rA ,�''':1•.•,k <br /> Ipp' Z A •p^',q', f <br /> IC r riiFieallon of recsi I of hazardous materials eeverod I is Ifes l once +as n d in Ito. <br /> . Faeill Ovrner or' tato <br /> q P�nt;,d/Typed N Siggorur. I n Day <br /> 111,flu, <br /> Y THIS LINE. ' -r <br /> DO NOT WRITE BELOW, <br /> 4 DISC$022A(1/991 Green; TRANSPORTER RETAINS' <br /> t EFp 8700— 2 '}" <br /> Ea ' d S9b0988 01 089C SbS 602 1098 1 Z->iS dd 99: b I 5661 21 Nnr <br />