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02/07/2006 17:18 9256340874 DILLARD TRUCKINr- PAGE 20/29 <br /> NA-HAZARDoUS WASTE MA <br /> NaFEaT <br /> Pira_n print or Type (Fart*+r19s,gned for ugo on e_Ut f 12 nitch,l NDc?,.vrt!!o <br /> NON.HAZARUOUS t•Go"rator's US EPA ID No, Muniieet 2 pagq <br /> WASTE MANIFEST C A T. D 0 () 2 2 5 � !�, 6 Document No. <br /> 1 'I ' 1 <br /> 3.Generator's Name 5 RIP 1K <br /> Maging A.ddros1 9 of <br /> s. MAMI ST COANT PROfft7 7rij, <br /> 11RCA �g9 5 VO 401 00249 <br /> 6100 R 14TC flMY 99 Rs *02GARITik, C.71 rw;s,'f <br /> 3TOCKT014, CA AT-TN: KYLZ Cl3R,I STT8 <br /> e.G mgrator'g Phone I ( q 4= ��0 .'i'lo-3 HY$�'3�4tTZ tl:yng <br /> ;.Tran;perter 1 Comp:uty Name 6. US EPA ID Numbar <br /> A.Stato Trangporte rs ID <br /> "LL.il a %19VTR(M iEl9'rAL "c;, C A D 9 $ 2 9 i B.Transportgr,P1)ono <br /> �,Trensporter 2 Corfpsny Name 8, US EPA 10 NUmber <br /> C.Sintn Tmngpertar'S ID <br /> D.Tran.^,porter 2 Phone <br /> 3.Deslgnatod Facility Ngme and Silo Adbmss 10, US EPA ID Number ^ <br /> E.State F,dUtys ID <br /> wt"n t"C. t,AMMFs 4j. <br /> co"q 900T11 hg-'?T'rN fK1AlD <br /> MANTIMA, CA .95336 F,Faculty's Phonc <br /> 9 0 13 11091992 429t) <br /> +.WASTE DEScalanoN <br /> 12. COnlairwr., 13 id <br /> T, Unrt <br /> Nn. Type Quantlry Wt,/VOh <br /> ft. <br /> G e. <br /> E <br /> N <br /> E <br /> R C. <br /> A <br /> T <br /> 0 <br /> 7 G.Addltlanat DescO066M IDr MRterlale Lisled Abovo <br /> H.Handling Codei lot Wastes Lleted Above <br /> n �1 is: �cl X47 �' r`•, ,^ ;�-'� /�' <br /> 1 S,Speclell Handling Irrtrvctlonfr grid Additional Information <br /> Q � <br /> "C Kvimr enay tattCa+� lg25y>&3A tSFISDIA. 3.LtA[iU <br /> Job 1 ,319 <br /> J <br /> Z <br /> Is-GENERATOR'S CEFMFICATION:I Hereby carnfy thai the wMents of tNa shipment Rre fully and accurtrtgly desalted end am In gil respecla <br /> In proper Condlbon for transport.The Materials do-chibgd on this menOest aro not gublect to federn]haTardQvs weak regul5tlong, <br /> PrintadTypomDate <br /> d Nae Slgnatury <br /> - ROACH V%%M MCO Month Day � Ygor <br /> FT 17.TraoaporlAr,acxnowledgomnrn of gdcebt of Materiel, <br /> A Prinfod/Typed tame owe <br /> Signature <br /> `t Month oaY Year <br /> SR <br /> p 18.Tr*r*PWer 2 Aeknowladgement at HAcalpt of Matorlala -` <br /> TPHM00 -Ved Name S{gneturo Date <br /> F1 <br /> R Month Day Yepr <br /> 18. <br /> F Disetaponcy Indloatien Space <br /> A <br /> C <br /> 20.Fadlryy Owner or OpwretGr,Cerflflcetloh of mcoipt Dr the waste mWerlata covered by thin manifest,except as rested Ir item 19. <br /> L <br /> I <br /> T Prlmedrryped Ngme S+gnsture Data <br /> Y Mom Day Yeer <br /> CF14 OM (000)52t58oe wwH.bD.vnaeter,com <br /> �,a�vrt�rr�itc <br /> ,t <br />