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F J <br /> a aRlllal i ty ways rn(ormatlon 'Shea fat <br /> Dim. to <br /> d4.i'' AyGeMfelq('J:USFF-PA,� .• la rest requiredbj Federal iaw.'�3•�' <br /> ek ` UNIFORM 1•IAZA'RDbUS' <br /> jumeniNo +::af.,. 1 <br /> ') WASTE MANIFESTa In iq 19 <br /> A. Slate Mamf(at Document Number <br /> 3. Generator,Name and Mailing Address R C• Anderson 894310 0 3 _ <br /> G jPaci„€i.�,,Gas & ElectrlC Co. \ pttn: -. Sstate.Generator•aW <br /> 65 rofD .$t. e Fresno. CA 9 i66 �) Stockton GLC HY H 3 6 0 018171918 <br /> 'a. Ge .,Phone( 209 263-5215 - C. sateT....Podsea lD <br /> /8. 'US EPA 10 Number <br /> N- 8. ransporteo 1 Company Name CAD- 0 6 3 5 4 1719 9 6 D. Transporier'a Phone n- U33 <br /> CO A <br /> STM <br /> ^• US EPA 1D Number E.State Transponer'a ID <br /> e. <br /> T. Transporter 2 COmPany Name - F.TrenaPWter's Phone <br /> po J - G. State Fs 'a IQ • <br /> m 9. Dealgi aced Facility flame and She Addraed t - :�+ �10. .. .i. US EPA'. Num4ert`� r <br /> Chemical• Waste- Marl gement/Kettleman_•Hi11s Facility x acilhY Phone <br /> 35251 01(1. Skyline' RoadA. <br /> < - Kehl amen Cit ' CA 93239 12. Containers 13. Total tis.~ w�a s.No. t <br /> _ Owntity unit ;:2-G3iJ <br /> Nune..ltaxard Gass.and U Number) .� .T�a Wt/Vol <br /> a- .: 11. USDOT Description(Indluding Proper,ShipPlOg _ Slate <br /> Oa " EPAIIRfner <br /> Z ' California regulated waste only - contaminated <br /> soil s.te <br /> N <br /> . E.:: b .. FfA[Dttier �.. <br /> o E1 4 3 i <br /> p �ts` �t�.�'rG�'�r�k,%.Te.r'`.iw.'�:".?45 S',� y.«v V, �fwy,.. > .5. c .2 qar' •- f,. �t Rn;^�.•S- iS 'c C.p <br /> r r�' ' .n :.s 3�5 r '># n i.= y rF i •,»� 5 a.� a ..` f k. . :f', <br /> `� • d 5 r ro� �. Kyr+ -, -. <br /> FP(11 <br /> W v '!t K '• P },c —W- <br /> A- <br /> A-0 <br /> :A-0 T <br /> \P' <br /> RA0 <br /> ..may. <br /> + �• _ ltalMgRg y41.� OM, 2^';�'^^y111�ormatlOat 'St' «'�' -Si , , 4!••9 '•• <br /> *�•' SU 4 r <br /> r �tlC` 'CY+a�r' t�tl9r�f-il�p <br /> } Ing.' `natdeding ar respire( s; ftIIs, ilti7-dusty <br /> c c M �{gey.durt c'on�i7iops <br /> .:: <br /> J <br /> U18 :wt :r ahiPpm9 name <br /> eked.marked,and ahead.end are m all respects N proper.condition for:banWNt pY laghwaY according to applicable Memplautl <br /> GENERATOR'S CE)iT1F1CA710N: I hereby declare that the contents of this conapnment are IuIN and acly highway.y.describedcr above by proper Y a r <br /> J 7, <br /> .J and are classified.W _... ,�; q,_ , , - 'I lova delsrmined <br /> Q- national government regulations. r•. . - - <br /> y the I ourteniy awlable to rale whifh m)nimixas the <br /> I f a eaC.on%IM e0Y practicable and the have selected its p ectiteble method of b"tonsnt eatorag posa la meted to the degree <br /> U present end future pract to human that Ih and the a ted the ra tk d I am a small quantity generator.I have made A good faith snort to mhdmhd my wears r <br /> 'Y .rad that I can eif <br /> •generation and"fact the best waste menageffwm method diet is available to me ord MOM ,Day <br /> .U ' S ture <br /> rW Printed/Typed Name - Q <br /> g' <br /> wT 17.Transporter 1 Acknowledgement of Recall t of M Oriels Month t7•Y -'Year <br /> Z -R _ Signature I o <br /> < A Printed/Typed Name- _ f _ G <br /> N <br /> U- <br /> 18:TnnapMar 2 Acknowkd9ems^t o elpt sl Materials t_ /,�on(A DaY Year: <br /> G..a.1.. Pdrd6dj r'ped Nama .; ,:' t `v`.: <br /> Slgnaw <br /> 19. Discrepancy Indication Space _ MAILED <br /> F <br /> A <br /> C <br /> I <br /> L Y t�noted in Item 19. <br /> 1 20. Facility Owner or Operator Cedilicetion of receipt of nazardoua materiels covered b this manilesl p / Mouth Day Year <br /> T Signature - <br /> y Printed/T ed Nama c t <br /> DHS 8022 A(1188) Do Not Write Below This Line <br /> EPA 8700-22 <br /> (Rev.9-88)Previous editions are obsolete. ( ^� Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS <br />