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'{AR.21.2005 4:10PM <br />utarnttr =nrvnmenral rrarecnon ngancy <br />Fort, OM9 No. 205D-0039 (Expires 9.30.99) <br />�r types. Form designed for us. on ■fit- (72—pitchy„ :wrifef. <br />10 <br />-m <br />eo <br />N <br />Yo <br />rz <br />W <br />z <br />w <br />a <br />V;W <br />K <br />Q <br />z <br />0 <br />a <br />z <br />t— <br />a <br />V <br />a <br />t/1 <br />O <br />rdz <br />W <br />W <br />C.1 <br />a¢ <br />W <br />O <br />N <br />Q <br />ii <br />M <br />NO. 518 I 8�G8,t <br />See Instructions on back of 64-26WDeporlmant oF7osdc Subsla c.s Control <br />Sacramento, California <br />DO NOT WRITE BELOW THIS LINE. 'I <br />Yollow; TSDF SENDS THIS COPY TO GbNERATOR WITHIN 30 DAYS, <br />ICoonorotvrs who -submit hafordeu5 Waste For transport our•of-stoto, <br />DISC e022A (1/991 prod.ce completed copy of this copy and cond to DTSC within 30 days.I <br />EPA 9706-22 <br />UNIFORMHAZARDOUS <br />1 • Generamr's US EPA ID No. Menifee Document No. <br />A$ 0 0 0 1 1 8 1 4 1 1 4 9 9 1 <br />2. Pae• 1 <br />1 <br />iaded areas <br />InFormalion ints sh <br />is nat a aired by federal law. <br />WASTE MANIFESTC <br />of <br />3. G gk _ySNQQ�r� �/�,p�j.J�J�yf�f� US <br />..lL u..Wu.. V1.LE +rW+.j1./�MiY X17 <br />A, Stat.Months}Dopumenttdum(v <br />�I � 1 r /� y nl I�•�' <br />12")00 W0VMiB0PJDUGH LUM ATM: JIM HARM MIT 24M <br />Y V <br />TX 77067 ( 281)874-2238 <br />� ��°� � �5 9 7 <br />A. Genwotor s Phone ( 1 <br />• (an■Parte, ornpany am■ '" •' 6. U5 EPA ID Number <br />C. S%vs TranipPMWs ID fReserved•I <br />RENWYATION, INC. C A R 0 8 0 A S 2 8 0 3 <br />D, Tronsporiers Phone <br />7, Tronsparler 2 Comp/any Name, B. U$ EPA ID Number <br />E. 51ate Transpgrow$ Ip IR *Wvjo,y <br />�j <br />�U5 EPA IQ Wenbw <br />_, a .- ---- -- <br />G. 5tahfoci liV1 10- <br />20245 IiM KVERLIE 800 <br />F{ FCeililYa (hone <br />ICEWT, WA 98032 IN A a 9 9 x 21811 7 6 7 <br />(253 ) 172—$121te <br />1 1 <br />J. <br />11, US DOT Description (including Proper Shipping Name, Hazard Class, and ID NumSe 1 <br />12, Containers <br />13. Total <br />Ouontl <br />14. Unit <br />Wt/Val <br />I. Wash nlumbw <br />No. <br />7 <br />X a' X DS 0111TRIBG P&III[l11k LE blown, O.D.S. (COiiThns Guam) <br />Slave 352 <br />€.1 Ql&31T3 PGIi bilG{)33I <br />O M1 <br />R <br />PPMO+;,r Iqla <br />tG <br />b <br />10j,V 10 <br />N <br />E <br />EPA/01hrr <br />R <br />A <br />c <br />State <br />T <br />C <br />4/r� 77 <br />EPq�ah.t <br />R <br />U <br />d. <br />Stith <br />EpAlath.� <br />Handling coder for Wastes <br />Quad Ahare <br />k <br />o. <br />d. <br />15, Special Handling Instrvctloris and Additional Information <br />PROP L9 J. YU LM -64 1XILITTY; SMICK 87010N, 2375 1. (zrPI11NT39, =7 SAS: 1315187 lUCTING ND.: EPPIN2082 <br />SML RQUS ENGUM' 119 WT11 3 WU &MMU ?M! 1-bQI1-424-Q91! <br />. 1 <br />16, 6ENEUATOWS CERVICATION: I hereby deelore thet the contents of this conal ni an fully and accurately described above by proper shipping (tome and ore ciassifred, packed, <br />labeled, in in condition for transport by highway occording to applicable inNmoeonol and naHonal a vernment ngvlotions. <br />marled, and and are ail respects proper <br />If I am o large quontiy generator, I certify that I haw P program in ploce to reduce the ,plume and toxicity of wart. generated to the degree I have determined to be ecanomicatl <br />eotment, storopa, or dlsposal cutrPntly ovallable to me Which minimizes the presets and ivlure threat b humors health <br />pragicable and That i haw selected t}Ie practicable melhod of 1 <br />and the environment; OR, If I am a small quantity generpior, I have made a good fgiHt effort a minimi generotlon and select the bei Mash manpgement method shot is <br />ovgilable tv ma anti that I can afford. 77 <br />Prinbd/Typed NomeMaMh <br />f' r• r / <br />Si9noturys,•' s��,.-�' rr ,�� /'�+� <br />' �� "A� <br />Day Year <br />r <br />j <br />r f f+? Jf r' j�a'' 'if r� �.r's <br />•r Y ts, <br />1 <br />17. Iron oriw 1 Aclmowleci■meet of Reeel t of Mato Hal s <br />Month Day Y., <br />A <br />Printed/Typed Nome 5ignoture <br />cl <br />S <br />Q�- <br />P <br />g <br />8. Trans rter-2 Acknowied errant aF Recai aE Materials <br />mom".. Gar Year <br />T <br />PriM■d/Typed Nam. Signature <br />o <br />19. Diseredoney Indicaflon Spoil <br />h <br />' <br />A <br />C <br />1 <br />L <br />1 <br />2 iIi er r O for Cenifieotion of real r of hazardous materials <br />cow, is manifest I as noted in Item 4. <br />r'Mo D Ye <br />T <br />ri ■ a a <br />ones <br />yl <br />r <br />Y <br />i <br />�(V(0 <br />DO NOT WRITE BELOW THIS LINE. 'I <br />Yollow; TSDF SENDS THIS COPY TO GbNERATOR WITHIN 30 DAYS, <br />ICoonorotvrs who -submit hafordeu5 Waste For transport our•of-stoto, <br />DISC e022A (1/991 prod.ce completed copy of this copy and cond to DTSC within 30 days.I <br />EPA 9706-22 <br />