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sw•of roved OMS rto,2 5D weuere(Expire, <br /> See Instructions on Beck of Page B Department of Nam"84NWOA <br /> Folin Approved OMS rip,2 e designed <br /> (Explras n*life <br /> and Front of Page 7 Toeb$"balance$Control Division <br /> Please print or type. (Form tlelgned lir use on.life(fTpnph lypewNlsr). 6,800111M116,cattlornla <br /> ,UNIFORM HAZARDOUS T70 PS EPA 10 No. —Manifest 2 Page t Intormallon In IM alleged area• <br /> WASTE MANIFE ICA D O S6 y O 2 8 7 S IDopumenl No� of / is not required by Pecaral fear <br /> 3 Oenerstoi a Name n0 Melling Add .1 <br /> s A. 8we IMnX,8M Doo <br /> Fis></Ert c C�ovv/,v?, va1L es-/,VO. P1v'1S/o,y <br /> 13/3 S. S 7 Ce710A/ 57'1-%6'Er, 40,06 CAG lF'O,evlA¢.fJ4 <br /> T'81,810, atay'e <br /> a. Denrelor'a Phone(ZQ� 3 d 9�-990l C1141,Q1316 <br /> i/ D / <br /> 6. Transporter I Company Name II JJ /N4 8. US EPA 10 Number C. SIM*JTraoep 4.$10 <br /> ry CNEM/CAL W.dtTt'MANAGBM! C I A I D 10 10131 9j 81 6 1711 D. TransporWa _ <br /> 7. Transporter 2 Company Name $. US EPA 10 Number E. State Tfanswal,'e 10 <br /> F. Transiplor Y Phone <br /> 1 0, Designated Facility Nam*and Sita Andrea, 10. US EPA W Number G. Slate Facility's m <br /> GNEIV/GA[ /.sASTm MnNAc6nv�rvr i(C, <br /> ` K.ErT�B!t9A/V N/<[-S ,cac/c/rr CiaiTiDiotqL'!6 it 1171 <br /> < 3S<S 1 UC J S/<YUME I?OAPj/<FTTL,EM Ai -- 1y CAL/fr36W H. FscXey',8 Phan <br /> MSI zrP-93239' ATD 06j41161'111171 f-8(X,7- ZZZ -,2960 <br /> 12. Container* 13. roll 11. 1. <br /> (�0 11. US DOT Description(Including Proper Shipping Name,Haaerd Claes,and ID Nembw) Quantity Unit waste Nig, <br /> No. Type Ar - <br /> N L) <br /> MZ ° �ALe/-l'kN/A RCGl1[A7715-0 STS ONLY n�3s2 <br /> �; hair <br /> UO D Or' . p FPA. N ,4. <br /> p0ort Eb <br /> R . slaw <br /> m A <br /> m T EPA/Omer, <br /> a 0 <br /> R C. tate <br /> EPA—/Nine, <br /> w Staff <br /> — <br /> F . <br /> U EPA'O1Mr <br /> w <br /> 2 J. Additional Daaa1P11«w I«Maiwlal Listed Above - K. Handling Coda,in,Y.pale_Listed Above <br /> w <br /> J <br /> < <br /> 0 <br /> r 16. Special Handling Inattuctiona and Additional Information <br /> Q = PROFIt� # sr U-N�139�9-o/s "70xe25-e // <br /> J <br /> � 16. <br /> U <br /> 0ENERATOR'9 CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately descr)bed above by proper eMPoing name <br /> and sre classified,packed,marked,and labeled,and are in all respect*in proper condition for transport by Kghway according to applicable international antl <br /> W eallpnat government regulations. <br /> If I am a large quantity generator,I tartly that 1 have•Prcyrem in piece to reduce the volume and IoxKJIV of waste generated to the degree 1 hav*4010mr0red <br /> to be economically practicable aM that 1 have selected the practicable mathod of treatment el«egs.«disposal Currently avagabl to me which minimises the <br /> present and future threat to human health and the eavironmom;OR,It I em a mat quantity peaam«..I have made a good felth effort to minimills my wells <br /> V generation and select the beat waste management method that Is available to ma 4,nIkal I can afford. .. <br /> U Pdnled/Typed Name Signalers Month Day year <br /> w <br /> Fc'E[� /3AUM�ACH P t.'2 �i <br /> MW T 11, Trasaportar 1 Acknowledgemen of Receipt of Material <br /> R <br /> Q A Print Typed Name signal we Month Day yew <br /> y' N <br /> ry s lin <br /> P <br /> w O Ie. ransporter 2 Acknowledgement of Receipt of Materials <br /> N <br /> U R Printed/Typed Name Signature Month Day Year <br /> E <br /> 19. Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> 1 <br /> 1 20, Facility Owner or Operator Certification of receipt of hassrdoua materials covered by this manliest except as noted in item 19. <br /> T <br /> y Prlatedt Typed Name Slonatw monDay <br /> Year <br /> OHs 8022 A(vee) Do Not Write Below As litre <br /> EPA.700-22 <br /> 988)Pr Whale: TSDf SENDS THIS COPY.TO DOHS WITHIN 3U DAYS <br /> EPA PSB)Previous*tlltions are obaglale. <br /> To: P.O. So. 3000, Socromento, CA 95812 <br /> 03/25/1998 "ORIGINAL MANIFEST COPY" <br />