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roue„ppruveu urvio iw.cu --1Lnyu co a-ov'a i <br /> • , -TW.se int or type. Form designed for use on elite -oitch t and Front of Paae 7 <br /> piWt ,Sacramento,California <br /> UNIFORM HAZARDOUS ienerator's US EPA ID No. Manifest 2. Page 1 Intormation in the shaded areas <br /> Document No. <br /> WASTE MANIFEST , 6 1 of is not required by Federal law. <br /> 3. Generator's Name and Mailing Address A. State Menffest Document Number <br /> IT.41D L�IPINRLPDRf B. <br /> CORP. B. State Generator's ID 00.)-1 f, <br /> 4STP%Jg�pon��Ll r 952015 4 4 - a , E NIMFR) H A IH 10 13 16 - 10 11 17 15 19 iS <br /> 0 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transpo ter's ID r <br /> Or/0 g, <br /> LO 1 �� ' D. Transporter's Phone O� RE—.5Z7,9 <br /> N <br /> U) 7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID <br /> w <br /> 0 1 1 1 1 1 1 1 1 1 1 1 1 1 F. Transporter's Phone <br /> 0 <br /> m <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Facility's 1D <br /> E TI CAP! <br /> 20,5 NEWLANDS DRIVE EAST a <br /> U � H. Facility's Phone, <br /> -d Z FERNLEY, NEVADA 39408N iD 19 iS 10 18 9 15 13 3 8 1-800-648-9931 <br /> ,.i. Cc 12. Containers 13. Total 14. I. <br /> w 11. US DOT Description(Including Proper Shipping Name,Hazard Class,and ID Number) Quantity Unit Waste No. <br /> .; <br /> -j Type Type Wt/Vol <br /> .q U a. 'I State <br /> Z NON-RCRA HAZARDOUS WASTE SOLID <br /> >� N (ZINC PHOSPHATE `FILTER CAKE) £� 1 C M 0 0 0 2 0 Y EA K <br /> 3 E b. State <br /> R <br /> O A <br /> co m T rAlOther <br /> v O <br /> N <br /> y R C. State <br /> O <br /> O <br /> EPA/Other <br /> ccLU <br /> d. State <br /> Z <br /> U.) <br /> U EPA/Other <br /> LJ <br /> Z I J. Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above I <br /> O a. fl 1 b. f <br /> a_ CORROSIVE MATERIAL Ct�'iPONENTS I <br /> Uj <br /> ZINC AND IRON PHOSPHATE 60 - 80 A� C. d. <br /> J <br /> 4 <br /> Z <br /> O <br /> I— 15. Special Handling Instructions and Additional Information t�, <br /> W WEAR PROPER PROTECTIVE EQUIPMENT WHEN HANDLING (OSHA LEVEL "C") <br /> ETICAII PROFILE ;a M91-078-0I <br /> J <br /> J <br /> < 16. i <br /> GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are 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 /> p, national government regulations. <br /> v7 <br /> If I am a large quantity generator,I certify that I have a program in place to reducethe volume and toxicity of waste generated to the degree I have determne <br /> id <br /> O to be economically practicable and that 1 have selected the practicable method If treatment,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 sm II quantity generator,I have made a good faith effort to minimize my waste. <br /> } generation and select the best waste management method that is available to a and that I can afford. <br /> U <br /> Z <br /> Printed/Typed Name I Sign a Month DRV Year <br /> C7 _ i <br /> LU 41/1' <br /> ILIA ijij6k' <br /> lU <br /> wT 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> Z A Printoo/Typed Name Signatur, Month Day Year <br /> < N <br /> LL S <br /> O P <br /> LU O 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> U) R <br /> QT Printed/Typed Name Signature Month Day ve.Ar <br /> U E �ry <br /> Z <br /> 19. Discrepancy Indication Space <br /> F <br /> A t t <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 "PMkted/Typed Name r Signature Month DAV') YAAI <br /> DHS 8022 A Do Not Write Below This Line v;r <br /> EPA 8700-22 <br /> (Rev.6-89)Previous editions are obsolete. <br /> allow,: TSD'r SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS <br />