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r t7e^cY <br /> r (f?xpia 93496) See Instructions on back page 6. Department of Toxic Substances Control <br /> ' Iter rhe on siNr(!?-pildt)IypewriMr. Sacramento,California <br /> lCfp►ors US EPA ID No Manifest Document No. 2. Page 1 Lnformaton in the shaded areas <br /> VS ��0 d d Z ry not required by Federal law. <br /> k ,t T r <br /> 3:calors Name grid Molting Address / �/I'�/N /� �S fest,Doevmenl; <br /> Alvueab,Iet;, e9. -9`IS'S`b �Ib Sfate Generators fD <br /> C4 <br /> 4. Gen rahors Phone00 <br /> 5. Transporter 1 Company Name 6, US EPA ID Number C�State Transporters ID <br /> v� f' <br /> ;RAMOS ENVIRONMENTAL SERVICES ICIAID1014141010 3 5 5 6 <br /> 7_Trans3ww 2 Company Name 8. US EPA ID Number <br /> s9. Focirity Name and Site Address 10. US EPA ID Number <br /> '- CHEMICAL WASTE MANAGEMENT, INC. <br /> 35251 OLD SKYLINE ROAD, KETTLEMAN CITY, CA 93239 <br /> CAT000646117 <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No Containers 13. Total 14. Unit <br /> .F _ No. Oanli* Wt/ <br /> V a•` a <br /> Y�y <br /> 4 <br /> U Tyr 6•6 Handling InstruNions and Additional Information 5/lL 7��f1 �y1�7 r T�lACrY��fp <br /> HANDLERS BE 40 HOUR OSHA/SARA TRAINED /-*.ry .9 <br /> LU AND USE NIOSH APPROVED PPE. per/✓ c/�. <br /> t- <br /> EMGENCY Comm (916) 371-5747 <br /> s I& C,ENERATOWS CERTIFICATION! I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> Q - packed,marked,and labeled.and are in all resoects in proper condition for tronsa. rt by highway according to applicable international cn.4 ge­emme^ re�ulatic:,s. <br /> rIf I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br /> d economically procticable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future <br /> rA threat to human health and the environment,OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best <br /> p� waste management method that is available to me and that I can afford. <br /> Q Prinfed/TYP?ll Name Signature 100, Month Day Year <br /> W <br /> su <br /> Z Tr' 17. Transporter 1 Acknowied R"pt of Rt of Materials <br /> R'. <br /> 0 A PrWed/Typed Name ign—a Month Day Year <br /> 1, 6 4 q <br /> :S <br /> r <br /> s,1 0 1& Trons r 2 Ac dement of Recei t of Materials <br /> "' to I Prfrnled/Typed Name Sigratur Month Day Year <br /> 0 E <br /> R <br /> Q19. Discrepancy Indication Space <br /> V F <br /> A <br /> L' C <br /> L. <br /> 1 20• Facility Owner or O erator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> T Printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> Whitet TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> DTSC 8022A (1/95) To: 'P.O. Box 3000, Sacramento, CA 95812 <br /> EPA 8704-22 - <br />