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Proletiian Agency ��r�r�. <br />dM9 1Jo. 2054-00.79 (Expires 9.36.96} 5@@ i�lf NCtlOflf Ofl Efaf -�% 9@ 6, Deportment of Toxic Sabtio"es co, <br />M.. form designed For use on @&@ (12i .9'PewTirer. k !. Soaurnento, California <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (9/94) <br />EPA 8700-22 <br />Green TRANSPORTER RETAINS <br />UNIFORM HAZARDOUS <br />1. Generators US EPA ID No. <br />Manifest Document No. <br />2. Page i <br />Information in the shaded areas <br />is by <br />WASTE MANIFEST <br />A L 0 0 0 1 1 5 0 8 <br />9 1 3 4 6 <br />1 <br />not requi"d Federal Jaw. <br />of <br />'! <br />O <br />3. Generator's Name and Mailing Address <br />A. State MoMest Document Number <br />n <br />RCO PROD=S CO AMT: NEAL <br />DhVL'IaFORT <br />04 <br />Po O, BQX 90877 9000 DAVENPORT <br />'SW <br />CHEMICAL <br />8: state Generator, ID <br />ra tAIN <br />$IO ) 3$2•-9.58 <br />R <br />TroCompany Name 1 CoName G. US EPA 10 Numbe <br />rDILLA <br />C. State Transporters 1D <br />J <br />RD TftI;CKi('3G, Ii;C.o:.Transpomr.:Ph. <br />(800y'"67$-1066 <br />J <br />V <br />7. Transporter 2 ComparryName S. US EPA Ip Numbe <br />E. Stat@ Transporters tD ' <br />Q <br />F. Transporter's Phone <br />Z <br />9. Designated Facility Name and Site Address 10. US EPA ID Numb, <br />G. Facifity's ID <br />0 <br />O <br />':1 1CAL 4'.ASTIIE MANAGEMEMT <br />` L � , <br />'L <br />35251 OLD SKY:..Ihi%'r'1 <br />KET:LEt4W. CITY, CA 92-39 <br />H. Facirryt Phone <br />(20).) .386-9711 .. <br />Z 11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) <br />12. Containers <br />13. Total <br />14. Unit <br />No. <br />Type <br />gQQ�rr t�i1_�� i3Rt?7CARF�OCd GOf,*:ALp� IP!A`f'LD SOIL) <br />3 a. b �I 1sAlir� 'rstAS <br />Quantity <br />WgVOI <br />1. Waste Number <br />S"2,' <br />✓lltilQUS i. SOLID <br />t <br />o <br />0 0 1 <br />;='• T <br />0 0 <br />Y <br />E@ I'9ftCRA. <br />f <br />`� b. <br />State . <br />E <br />IZ <br />A <br />EPA/Other <br />m T i c. ,.. <br />sate <br />O <br />L <br />LR <br />EPA/Other <br />Z <br />d. <br />u,.r <br />V <br />Stata <br />U <br />! <br />EPA/Other <br />0 <br />:J: `Additional Descriptiorss'for Mater4is.listed Above <br />1lA) <br />K. Handling Codes for Wastes <br />listed Above <br />PROFILE #As7' 1423 <br />�tQ'-171,., <br />a. <br />b. <br />LU <br />1��. <br />J <br />Q <br />Z <br />0 <br />Q <br />i5" Special Handling Insftructions and Ad i�4onof Information <br />17e• r P.P.L'. {1.@., z'txzwr CxOvest rub', -t= �OQt.a <br />?4—):OL'3 11?C'Zc;i?C:G'�r felr>E+:ianc-? <br />Z <br />CcAiVe clothing, nn3 ;iratoj:, ;o,,.ic , e.c. <br />( JL_]) <br />10- ..^rU';RC `:c3 <br />z <br />20 � 'i', '. STr11:!:T <br />V,1 �y <br />t��. 11 C7-112. <br />Q <br />16. GENERATOR'S CERTIFICATION. I hereby declare that the contents of this consignment <br />packed, marked, and labeled, and are in oN respects in condition for Transport b <br />3re fully and accurately described above by proper shipping name and are classified, <br />highway " <br />U <br />proper <br />according to applicable international and national government <br />ng pP g regulations, <br />If I am a large quantity generator, f certify that I hove a program in place to reduc <br />the volume and toxicity of waste generated to the degree I have determined to be <br />Neconomi<olfy <br />practicable and that I have selected the practicable method of treatment, <br />threat to human health and the environment; OR, if I am a small I <br />storage, or disposal currently available to me which minimizes the present and future <br />have <br />Cewaste <br />quantity generator, <br />management method that is available to me and that I can afford. <br />made a good (pith effort to minimize my waste generation and soled the best <br />j <br />Printed/Typed Name (•- Signature <br />/ i, i= Month pay Year <br />~ ~ <br />Z T <br />w 17: Transporter 1 Acknowledgement of Receipt of Materials <br />R <br />, , <br />_ <br />0 A Printed/Typed Name Signature' <br />tY N y. j J <br />�' Month .Day Year. <br />,1r O 18. Transporter 2 Acknowled ement of Recei >1 of Materials <br />,LPrinted/Typed Name <br />,J E <br />Signature <br />Month Day Year <br />R <br />n19. Discrepancy Indication Space <br />Q F <br />J <br />A <br />Z C <br />1 <br />L <br />t 20.e Facility Owner or Operator Certification of recei i of hazardous materials <br />covered by thi <br />i manifest except as noted in Item 19. <br />YPrinted/Typed Name <br />Signature <br />Month Day Year <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (9/94) <br />EPA 8700-22 <br />Green TRANSPORTER RETAINS <br />