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10- 2-06: 4:49PM;YELLOW ;913 344 3614 # 26/ 33
<br /> Stete of Ca1i6nio--Enviraom.nta1 Protection Agency
<br /> Foim Approved CM/BNo.205G-0039lE.Piree9-30-991 is See Instructions on back o e b. [kporlmenl aF Toxic Subafa7pc"as Control
<br /> ' Please printorype:: Fomdyigrndforuieon.lib(12-pikh)ypewriler. Saoamenb,California
<br /> - - 1. Generolor's US EPA ID No. Manifest Document NO. 2. Page i 1.1onrtnfion in the shaded areas
<br /> UNIFORM HAZARDOUS is not required by Federal law.
<br /> WASTE MANIFEST l Ili Ii 1 - , I I of
<br /> 3. G.nerarors Name and Mailing Address A. Sala MoulFest Document Number : ryq
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<br /> A. Ganemrors Phone 12091-4 C16 -19412
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<br /> h 5.Transporter l Company Nome 6. US EPA ID Number C.Stale TmnspWr`,ID JR—ryad.I -;
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<br /> g CONSOLJDA11D WAS1L. TNI(, 6, i -' S 1 DPhono
<br /> 7.Transporter 2 Company No S. US EPA ID Number E. Slate 7 porter's ID IReservad.l -j
<br /> n da _ F. Tran pan s Phone t
<br /> I1'U 9. Desi acted Facility Nome and Site Address 10. US EPA ID Number G S t FaoA tri 1p
<br /> a-1<_ C.11W3�fY AND OVt dt 11V
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<br /> �2�dT.,DNG PEACH, CA 9081,3 x P 1 L d ) 9 .1 9 562- 4;ti� 51nS v 12.Container 13. Total 14. Unit
<br /> 11, US DOT Deacrtptian(Including Proper Shipping Nome,Hazard Class,and ID Number)
<br /> sa Na. T e Quanli WtNel I Waist.Nam6er
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<br /> Z 00IN WM HAZARDOUS WAST•F' ())_.Tl) st to 352
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<br /> 1S. Special Handling Instructions and Additional Interaction A-1z25>i
<br /> WEAR APPPOPRINIT: SAFf'I i U)UIrVW- C S.-
<br /> ' Z 34RR L'IUF.R(:i}:MT CChu"rA-Cr.1-T3E RARF'IEI� D/5).0.638 .VS84 C.':
<br /> STT£, ADDRESS: SAME- AS 0Y1^NETATOR Pr-
<br /> -u 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of Baas comiroentor.Fully and ae<uralely dm,,ibeda6ove6yproparshi, Ing ....ad. do ss1Red,pocked,
<br /> marked,and labeled,cod are in all respects in prayer condition for transport by highway occarding k applictbl.Warvational and nafonal government re9u6Sons.
<br /> zi IF I am o large quen8'K
<br /> generator,I c.Oily that I have a program to place to reduce the volume and toxicity of waste generated to the degree I have determined to be econamically
<br /> i practicable and that I hmre selected the pradicebie method of Iraohnenl,arorage,or disposal currently available to me which minimizes the present and Future threat to human health
<br /> W and m the anvi,. mtj OR,iF I am.small quantity generator,I hove made o good Faith eHoet ro minimize my waste generolien and soled the hast waste manag.ment method that is
<br /> 1 ac available b me and than i can chord.
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<br /> / ., .-= Month Day Vea
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<br /> w T 17 Trans Mer 1 Admowl.d .marl of R..i I of Mabriols
<br /> a' It Pggled/Typed Na a '� signature Month Day Year.,,,
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<br /> 0 18. Tram error 2 Aclmowlod emam of Recei t of Materials
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<br /> (aj 19. Discrepancy Indication Space
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<br /> i I 2D. Facility Owner or Operator Certification Or— l of hazardous materials covered by this manifest exc t as noted in Ilam 19.
<br /> T Printed/Typed Name Signature Month Day Year
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<br /> DO NOT WRITE BELOW THIS LINE.
<br /> Blue: GENERATOR SENDS THIS COPY TO DISC WITHIN 30 DAYS.
<br /> DTSC 8022A(1/99) To: P.O. Box 400, Sacramento, CA 95812.0400
<br /> EPA 8700-22
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