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10— 2-06; 4:49PM;YELLOW 3 344 3614 # 30/ 33 <br /> • . HAZARDOUS WASTE MANIFSST <br /> NNNNNNNN OF)NATURAL tESOURCE - <br /> ENVIRONMENTALbIVk31ONOFQUALITY j THIS DOCUMENT MUST BSUSED FOR ALL MISSOURI-DESTINED SHIPM1ENTg <br /> - <br /> Hazardou@Waste Program,d 66102 INSTRUCTIONS <br /> P.O,Box 176 Jefferson Cltg MISeopFOR THE COMPLETION:OFTHIB FORMAIiE IXNASEFxRA7E SBHEET, <br /> - <br /> 673-751.9176 - EMEfl08N0Y LLB.CDABI'pgAlO CH[M1nao DEPT OFNA1UFkAL <br /> 1` RF8pON0E 1-0a0.91d:6epa Ieop{t{.p3pe REMDUno <br /> - 6fe•fi'JC•R13E1. <br /> 1I -Please print or type{ Onn 000,0 gd.br use on elite(1g-path)typewrter.) Fwm Apprdved OMB No 2000.Op89, <br /> UNIF,081If,,i)AZARDOUS Ganamtar4 UB EPA ID No Mullett z, Page Inform9tbn in the sMatlbd hBaS <br /> WASTSMANIF�$T oocumertNo <br /> ' , t IS fegllirtld bX_Slate law. <br /> 3 Gageramr5 Nand slid MafngAddress <br /> ROADWAY; EXPRESS, INCORPORATED I <br /> 3233 LOOMIS ROAD <br /> STOCXTON CA 15205 <br /> Ganeretors.Phane,( qjjq ) 466-290 <br /> b:Thooponer 1 Cmmpemfv Name a.US EPA 10 Number - <br /> N . <br /> ' 7.Tredadotter 2 CampanY Nerve e.U6 EPA ID Number H <br /> . '. ENGLUNQ %JI /I9,15/.JT �� $ Z H2O J" (a . Q <br /> T.Designatetl Facility Name entl Site tlreee 10.US EPA ID Number a <br /> HERITAGE ENVIRONMENTAL .SERVICES'LLC y <br /> 855 38TH STREET ti <br /> O <br /> U <br /> SA CZTSC 641 <br /> {t US DDT Desalpidn ffhchacing Ploper,Shipping Name,Hazard Gast ID Number ana Paamg Group(f any)) 12.0ontainars 13. 14, a :. <br /> Number <br /> Total Unit s: <br /> ,'Type OuanOty Wwd. LL. <br /> : a WASTE ELA11MABLE LIOUXDS, R.O.S. , 3, � • <br /> UIU993, kII '(NAPHTHA) ERG #128 Q <br /> -� ' <br /> Lu <br /> W <br /> IT (5 <br /> a <br /> NOW <br /> all <br /> w <br /> a P`C ttW Ss0 <br /> 11Y , <br /> '.taopac gh O Add4pnel Iniprmatlan <br /> { ti EBlerlgeo�Y;Phahr?,#. i8R0) 326, 122E <br /> w <br /> Ic <br /> 'q".ud ni InaM mOenbr In proper .Ihereby dedeie that by highway <br /> althis conalghmem ars fully and eacumtarydescrmadebOweygulators airports namaand aro rogubleo,pecked,marked;endGheled, <br /> and Pre In gMiecpecain proper condabn for transport aY highwayaxortling to applke.Nh" tnatbpalaM mtianalgpvPmrnent'repuletl- entl appllcsde elate re(Nletbnq.' - Q <br /> 01 a Mrga quangly generator,I tangy Nat I haws program il place to reduce the noNM4 end toxicity of Waste generated la me degree I have determiimd As be eednomically praclkaete and that I' � <br /> Feud eatadad'me preclEetik method at treetmek storage,a disposal aunently nsdi a to me which on nlmlms the present and luture threat to human health and the environment.OR,q I am a Wall OF <br /> quanmy,ganorow.I hamedw' e a good lean effortMY W minimize tvesla generation arMa leen the best waste m- ape meth able to that I can afford. <br /> I Prime. etl� KM/'T'1V�. .Signature Month Dai Year Ic <br /> W <br /> T...,7 <br /> report t ApknaNe ...eM Reaatpt o1 MaterialsT- Data <br /> A N ed N" al' W <br /> .N. / M nt Dq-,. 1WePf <br /> P N j /. y�GJ m <br /> '0 t@Thim „er 9 A*&Wle tent o{Raffelpl atMaterlo4 - Dd` W : <br /> Y P n,wYly�iM Name .. �. 8lgneture Month OR War ? <br /> eR. a <br /> . 1g,dWnpylby.Intllppgon.SDIWe ¢ <br /> U.11 <br /> F" <br /> F- <br /> 0. <br /> L.. <br /> 1 <br /> V 20.Deslgnaled Facility Owner or Operator:Cengkatlon of rmotor of hazardous materials covered by thle manffeatem <br /> expt as noted in tem 19. O <br /> Date O <br /> drlyped Noma / Signature Day Year <br /> U rD <br /> + <br /> worth Lo <br /> DaYear <br /> Or <br /> EPA FORM 8700.22(REV.1-99)MDNR-HWG 10 PREVIOUS EDITIONS�ARE OBSOLETE MAINB EU: D <br /> RECYCLED!'APPA WHICH~ ~ <br /> INCLUDES NOT LEGS ED20X ppb, <br />