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form Hpprovea OMb No.zuou—v tupuaa 5-ou o ana rront of rage ! <br /> °mese -.pri l or type. Form designed for use on elite ' '-oitch typewriter). i�s >1 Sacramento,California <br /> UNIFORM HAZARDOUS ienerstor's US EPA ID No. Manifest 2. Page 1 Information in the shaded areas <br /> Document No. <br /> WASTE MANIFEST 11 J6 in 1j;I Ir <br /> ,z Q - n K of is not required by Federal law. <br /> 10 15 <br /> 3. Generator's Name and Mailing Address A. State Manifest Document Number <br /> SDMIDEN WIRE PRODUCTS-CORP. 909- 21M <br /> ° <br /> 1422 EL PINAL DRIVE STOCKTON, CALIF. 95205, B. State Generators ID <br /> 4. Generator's Phone( ) n 466-0.24 our 14 IA 11A IQ 1.4 1r, I— <br /> 0 5. Transporter 1 Company Name 6. US EPA ID Number C. State Tranaplxter's ID^'1 <br /> LO <br /> rn2 D. TranspoMer'a Phone <br /> IC <br /> C\1 <br /> 7. Transporter 2 Company Name B. US EPA ID Number E. State Transporter's ID <br /> o F. Transporters Phone <br /> 0 <br /> m 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's ID <br /> CHEMICAL WASTE MkIAGEMENT `, <br /> U 35251 OLD SKYLIRE ROAD H. Facility's Phone <br /> KETTLEMM "z <br /> Q 12. Containers 13. Total .. 14. I. <br /> O 11. US DOT Description(Including Proper Shipping Name,Hazard Class,and ID Number) Quantity Unit Waste No. <br /> •.y t1L No. Type Wt/vol <br /> J <br /> C¢J a state <br /> c <br /> Z G NON-RCRA HAZARDOUS 'TASTE SOLIDif• f EPA/Other <br /> E F ' . / <br /> N State <br /> ..� E b. — <br /> ,' 6, R <br /> 0 <br /> m A f EPAIOther <br /> 4 O <br /> R c t State <br /> o i IU ;; � "' EPA/Other <br /> ro <br /> Cr d. _ state <br /> w <br /> Z <br /> LU EPA/Other <br /> U <br /> w <br /> U) J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above <br /> Z a. b. ! <br /> LU <br /> SWEE�PSINGtSc -� MAINT. CLEAkIilP MATERIALS USED DRAWING <br /> COt��'tDE:�1MS c d <br /> ¢ 1 <br /> Z <br /> O <br /> Additional Information <br /> 15. Special Handling Instructions and <br /> Z (H,`kZ. BVKJ- BULK, DWS 13GX `C" REW IN EVENT OF Ef-iERGENCY CONTACT <br /> U41 PROFILE # AJ1371. 04MI AT (205) 652-9721 <br /> J <br /> J I <br /> U 16. <br /> GENERATOR'S CERTIFICATION: I hereby declare that-the contents of this consignmentare fully and accurately described above by proper shipping name <br /> and are classified,packed,marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and <br /> d national government regulations. <br /> U) <br /> IrIf I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have detPrmine <br /> O to be economically practicable and that I have selected the practicable method of raatment,storage,or disposal currently available to me which minimizes the <br /> present and future threat to human health and the environment;OR, if I am a sma quantity generator,'[have made a good faith effort to minimize my waste <br /> } generation and select the best waste management method that is available to m nd that I can afford. <br /> U <br /> Z <br /> Printed/Typed Name Signa Month Day Year i <br /> W WAYNE F. MNIINOR � � <br /> L T 17. Transporter 1 Acknowledgement of Receipt of Materials ! <br /> R <br /> Z A Printed/77yped Name Signatur Month Day Year <br /> ¢ N J, <br /> LL S <br /> P <br /> w O 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> Cf) RPrinted/Typed Name <br /> Sign Tei` Month Day Year j <br /> ¢ T <br /> U E <br /> Z R <br /> 19. Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I �I <br /> L <br /> 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> T <br /> y Printed/Typed Name/ �' Signature - Mcnth Day Yaar li <br /> DHS 8022 A Do Not Write B ow This Line <br /> EPA 8700-22 <br /> (Rev.6-89)Previous editions are obsolete. <br /> � �j Yellow: TSDF SENDS THIS COPT' TO GENERATOR WITHIN 30 DAYS <br />