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Protection Agency W.y See Instructions on back of pcge 6.R �; UpepQtn;.e of rain satisiaK.�e«� <br /> .: Pane Approved OMs No.2050-0039(Capirw 9.30-96) _ Soaam.me,Substances; <br /> - <br /> • PPrb w type. Farm d.,;g d for w on.kft(17 . <br /> _ s US EPA ID No. Manifest DoaAnJW. 2. Pace 1 I Information In the shaded areas <br /> UNIFORM <br /> HAZARDOUS p ' / �0 A y d ' ' b not required by Paderd law-.. <br /> WASTE <br /> 3171 <br /> G3. C,,.,,W,Nan,and Moping Address Asp r,PS h•�- 5►�S�c�-`r riJ C �1 <br /> Av-0 <br /> 't, .. C samwe-Ph.. 1101 ) ZS-?ie Ico 9 CAp 5 234 <br /> S. Transporter 1 Company Name 6. US EPA ID Number <br /> Go <br /> ,�, C woogI'll <br /> 39z <br /> 7 T e 2 Company Name 8. US EPA ID Number <br /> u G.� <br /> q, haled j«ir Ngms aid Si,Address 10. US EPA ID Number <br /> Z 1CI:SOI1r 1rC. <br /> O s <br /> 255 Pa.-r Blvd. <br /> Richmnd,CA. 9480? C C 0 9 E A <br /> a ;. <br /> V 12. Come.. 13. Tatd 14. Unit <br /> Z 11. US DOT Description(Inducli ng Proper Shipping Name,Hazard Class,and ID Number) No. Type n <br /> = Wt/Vol <br /> nr <br /> " MON-RCE-1A Hazardous Waste Solid <br /> 3 O Waste E,•npty Storage Tank AID AC.SwATCO PIPE oitio TIP r3>111114P <br /> a E <br /> N R b DS a D <br /> A <br /> m T <br /> R ° <br /> � R <br /> w <br /> Z d <br /> U <br /> Z <br /> Z <br /> 6 <br /> OC <br /> J <br /> Z <br /> Z <br /> O SP•cci^1 Handling ksshvdions and Additional Infometion <br /> a Keep away from sources of ignitiovn. A)l)w-lvs ,w=ar hl�acs w?:er. work--nq_ arou lr9 <br /> Z U,G.S.T. 's 24 Hr. Contact Name._l1c�•yO.�Pn��S <br /> w <br /> J 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of isle consignment oro fully and accurately dewrrilpplica le above li Proper shipping name am am classified, <br /> Q pocked,marked,and labeled,and aro in all respects in proper condition fa transport by highwvy a:cordng ro applkable imenMiorel and national govemmat repulalians. <br /> V <br /> N 1 an a kxge quantiy gerwraror, I certify that I have a program in place ro radars the volume and al urn of waste bletotm ro the decree I have determined ut re <br /> ti <br /> economically practicable and that I have elected the practicable method of iroatmenl,sloro9e,or disposal currently ovnilabb ro ma vvinidt minimizes the present and future <br /> rn threat Is human health and to em ira mernt;OR,R I am a small quantity generator,1 have made a good faith effort to minimize my waste generation and elect the best <br /> waste management method that is available to ass <br /> and that I can afford. � <br /> '� <br /> rimed Year <br /> O ypod N (f I 0 Sig9 O ✓ � Z <br /> G <br /> Month Day <br /> U <br /> Z 1 17. ram r 1 Aduawled <mem of Recei t of Materiah Year <br /> w 1 Primed/Typed Name S.g N Q <br /> wR <br /> i I I �x,' c <br /> Wp18. Trvns r 2 A wbd ement of Receipt of Mut-rials <br /> W 1 Printed/Typed Name Signature <br /> Month Day Year <br /> O 1 <br /> It <br /> N 19. Discrepancy Indication Space - <br /> A 41 b Nor A2ceP-Q�0 h5 yeGP&2, Lr�E 1Twn <br /> U A <br /> Z C <br /> 1 <br /> L <br /> 20. Facility Owner or lo <br /> var Certification al recei t of haxardoas materials covered 6 this manifest exceptas rate in Mem �, Year <br /> T Primed/Typed Name Signature ^ <br /> 0 • � o � 03 [ <br /> DO NOT WRITE BELOW THIS UNE. <br /> White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> DISC 8022A (1/95) To: P.O. Box 3000, Sacramento, CA 95812 <br /> EPA 6700-22 <br />