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Planse pfini or typo,(Form cosi nod for use an elite(12-pitch)typewtiler.) Form Approved.OMB No,2050.0039 <br /> UNIFORIA HAZARDOUS 1•Gonomter ID Number 2.Page 1 al 3.Emergency Respanso Phone b.fdanifest Tracking Number {{� <br /> WASTE MANiFE8T CAL000279992 1 16-371-5747 O 793 <br /> 20 JJ <br /> 5.Genemlofs Nome end hiei{ng Addracs Genom[Gen S1leAddTe5s(if difrereni than maMolg addrass) <br /> VANOERLANS A.ND SC)NS INC. <br /> 1"20 S SACRAMENTO ST <br /> LOD1,CA 95240 <br /> Gera ratces,Phort 09.334.4115 <br /> G.TransMger t Company Noma U.S.EPA iD tNumbor <br /> RNAOS ENVIRONMEKAL.SER=ES INC. I GAp0d4fA33555 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> 0.Desfgna;sot FaulityNama and Silo AddressVEOLIA ES TECHNiCAL SCdLETSI>_1NS V.S.EPA ID Number <br /> 1125 HENSI EY S'I'RES" CAT080014079 <br /> RiCHMOND,CA 94531 <br /> Fac+6 's phono§00-2413-2W2 <br /> pa. 9b.U.S.DOT Doscripl on(inc'udmg Peopiv(Shipping Nnmo,Hazard Class,ID rlumtor, i).Containersti,•Coral 12.Unit <br /> Hh1 and Packing Group(Jany)) No. Type CuantTy V�t,Voi i3.lVasteCodos <br /> Od 1. Ur&Ci77, 'NASTE ENVIRONMENTALLY KVARD13i,19 SUBSTAr1cES 001 Dry a 181-DOW - 7 <br /> 30{3 <br /> SOUR,NOS,9,PGIII(CHROMIUM.CAOMIUi�} �5Q _..._..,_�._ <br /> a. I <br /> i <br /> LQ <br /> g ( <br /> DEC 2 2 26I6 <br /> _ —A . <br /> i <br /> a. ENVIRONMENTAL <br /> tIcglTi-I n':PARTAA`~RT I i <br /> 14 Spatial Handling instrucbens and Additional Information <br /> 9B-1)PROFILE; ERG#171 5 0 1Js7S <br /> E.R. CONTRACTOR: RAMOS EN"ARONmENTAL <br /> HANDLERS SHOULD 13r-TRAiNED AND USE APPROVED PPE <br /> 1Xs5' <br /> 15, GEftERATOR'SICFFEROR'S CERTIFICATION: I hofcby dedaro.that the con!ents of this conelgnmmntare rally a"'J acarlaty doscnbed abew by me proper shipp{ng name,and era c issifed:paci,aged. <br /> marked end tabcNdlplaearded,and oro in ah respeclsin pmpercoodr6on,for rrarrs;,cn aaordmg le 4vPlic8ble int9m0onatand narwtal governmental Tegulal;cns II axpon shipment and t ael the Prmary, <br /> Expona,i cartify that the contents of this consignment coornm to aw terns of uie airachad EPA Ackrkaviedgmelm of Cori sent. <br /> I cenity that!ha wasto min•nization slnlmnonl Iden reed in dG CFR 262 271a)(III am a targe quan5ty generator)or(b)(ill am a srnvJi quant iy generator)is no. <br /> Gene aro a pEarofs PrintadlTypod Namo Si aturo kionlh Day Year <br /> Q C. ar `iv- (-,. <br /> t5.fntomatl hipmanis <br /> h ❑Lmport to U.S. Expen fa"U.S. Port of en rylexih�r_ <br /> TransPo -nets nalure(forex Jk^rlsoni <br /> g y) f?a!e leaYng U.S.: <br /> 11.hen parcrAc na.,iadgmeni of Reca;pt of tlaiertals <br /> Ttarupo ter i NrinlodtTyped Name -- ---- <br /> Signature MD;lth Dny Year <br /> 0 <br /> CL /vL./r/..T -r9 JC''✓r .,.LSC! -- <br /> Ttonsporter 2 P te6ly�d Nareos 1z 2 <br /> Signa,re Month �Day Year <br /> ta.Dlscrapancy <br /> t0a.Discrepancy Indication SpaceQu �fi <br /> ❑ antity ❑Typr� LlResirlue ❑Partial Re)ectx;n t„JFuRRareGicn <br /> tsanitest Reference Number. <br /> t8b.Al,ernalo Facility(or Gensralar) ^� U.S.EPA ID Number <br /> c3 <br /> sy FacTity's Phone; <br /> r I $ignaluro cfA1!emato ForJlRq(or Gonoralor) T <br /> pay Year <br /> KL <br /> ---- -- <br /> 19.Hazardous 1Vasto Report hlanagoment ifolhod Codes(ix,,cedes for hazardous wasslo treatment,disposal,and tecycring systems) <br /> Uj a 1 /// / 2. 3. d. <br /> 20.Designa(ad Fad;iy Otvnsr or Opsratgr:Con frcatlon of recaiptof hazardous materials covered by the manlfes!except as noted in Item IBB <br /> Pdnt Kall a a ldanh Day Year <br /> EPA Form 8700.22(Rev.3.05) Previous editions are obsolelo. DESIGNATED FACILITY TO DESTINATION STATE(iF REQUIRED) <br />