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k <br /> R - niolaL, r n lsnne ;. <br /> 1, a alor`e' SEP iD .- z of is'eoCreoulrea bY-PaEerYlTaw 8 <br /> G. �. <br /> ' RC1 S ��•,., c .. ! o omen!NO' '?� '4 ' <br /> TE MANIFEST CAD 9''8 0 8 8''6 $ '7 `3 A State Me "eat D omen N e <br /> ere 's Name and j.1e11ing Address 1 ' s - 1 C. :Anderson - <br /> 89406 <br /> Pacific Gas &. Electric CO.., Att I( B.state Generators to <br /> 650 "Ott St. , Fresno, CA 93760 ltd 1 Stockton GLC Hy- H 3 "6 0 0 8 7 9 8 <br /> 20 263-5215 er-a ID <br /> {. Generetora Phone( __A W ,,,,_� C.State Treer' P 6Q <br /> e. (,j 5"Grit <br /> n 6. TnnaDorter 1 Company Name G D:Transporter' P _ <br />'� US EPAID Number E. State Transporters ID <br /> e. <br /> n 7. Transporter 2 Company Name - F.Transport 'e Phone <br /> m .. . i {t <br /> p s { tate Facllilya <br /> 10. • .' US EPA Num r <br /> m ..... g. Designated PAdltry Ramaand SNe Address - <br /> Chemical`Naste Management/Kettleman Hills_ Facility <br /> w FacumaPhoaa <br /> 35251 Old Skyline Road �' „ _ <br /> CA ;93239 A T- 0 4 6 1 1 7 . <br /> x Keti<te�an 'CYa ` <br /> Z _ 12.COMaMere 13 Total ity Unit Waste No <br /> p ud Proper Shipping Name•Hazard Cleaa;end ID NwnbwJ . No. Type - WUVoI - <br /> 0 _, - 11 US DOT Description Gncl ktg` _ State sri "'KY3 <br /> - contam%ated 6 : <br /> '' California regulated waste only soil FpAra „ rte = <br />? u _: 0 1DT000 Y <br /> s*s� <br /> E <br /> E b. - - a EPAYQIMr <br /> r t. �.�,�"d::T�,�n+�A.v�'�'r �sa�y ,-. a yy�y,�yx, u x +:' r <3. 14 •� <br /> a) :�,r ��•lr+tA'4-'��� �+5^.3`= .,Fad-'ati+l�a7- Y r �S� �[.. 1 to <br /> y d <br /> tet ' <br /> n x <br /> 'TR.. <br /> W <br /> N <br /> Z ). <br /> G <br /> i ^u <br /> Z Near{i"OteCl <br /> W <br /> du <br /> � ra ng <br /> J - - <br /> 16. • ' nt are fully and eauratetY described above by ProP�aMDPm9 name <br /> GENERAT011 S OERr r^.RC'ON i 1,arabY'daciaro that the contemn of this cW.cnma b hi hway accord' to aDPiKable 4derNlbnal end <br /> J ad and labeled.sad are m ap roapacts N plops!-condnlon for transport Y 9 <br /> nrM aro ckeesied.packetlwmerk r 1 _ `+• <br /> a - national government fall Iona. .; rY.. _ 5`•�= 1 hew delermnetl <br /> N 4 ter.I oerNy thnil haw a pfognm N'pieCA to reduce the Ydume AIM tozkiry nt Wil e911°rtMtN a�vAe N t rM Whkh min4ni2ee the <br /> S .N 1 am•Wge 9usetBy clicable method of treatment.store ar diapo <br /> O - to bs a lame caan Meet ble aIW that 1 Mw seledled the Pre uemity gmlent" I haw made a good faith eNort to minhnae my waste <br /> present and fuhhe lhr" o human toralth and the envir°"ment..is av ll am a emag 0 <br /> V _generation and select#0 beat waste management method that le evagabb to ms and that 1 cnhagatl Monts DAY Year•' <br /> S19na re /l O ` - <br /> QPri ted/Typed Name M Li <br /> g2j -T 17. Tnnapoder 1 Acknowledgement of Receipt of Materials _ Monfh OaY Yser <br /> 6S`°"` u 10 g 8 <br /> Z A Printed/Typed eme <br /> a <br /> O <br /> Materiel°s . <br /> .P 13. Transporter AcknewletlgemeM ofRecelpt of lb Day pay '.Year - <br /> Signature;..' "t t . 1 - <br /> T PrinWITyped Neme r.E . <br /> E — <br /> 19. Dieaepency Indication Space _ haHILEh <br /> F 'P, ,LV <br /> A <br /> C <br /> 1 20. Facility Owner or O tion of receipt of hazardous materiel°covero y this manifest Cepl as not <br /> in Item 19. OSY Ye <br /> T S19naWre <br /> Y Printed(Typed Name <br /> \ Y <br /> Do Not Write Below This Line <br /> DHS e022 A(tree) <br /> EPA 8700-22 <br /> (Rev.9.e6)Previous editions are obsolete. ' /�0 ` ' Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAY <br />