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sN pl Cel.foma—Em"ra^�^eobl reNCMnAg axcy - <br /> QQ err ' 4 <br /> me <br /> to"pro,aedyine fa 2050d10dleatipnn.1,401 Sts lnshuehons on back of pa�. Dapartmeotof Ted. Californiar <br /> ww Pgnt M type F°An�+rBned for afe a^elrM1(11 plbAl ypee' Se<rommto CaLfom <br /> UNIFORM HAZARDOUS I Generator•US EPA ID No Mam6tl Document No 2 Page I ornwnon m the+hoded arova <br /> + n not regoved by Federd law <br /> WASTE MANIFEST CAL 0 0 0 1 7 9 3 2 3 5 2 0 1 9 1 of <br /> 3 gofse'o+[fa'rkji+4tegA(iompany site Location R -r *, <br /> 2000 Crow Canyon Place Ste 400 yq1,• ` <br /> Service Station R <br /> San Ramon, Ca. 94583 A 6981 <br /> d Genewbr+Phane 1925 1 277-2305 <br /> 5 Tw^+ er 1 Company Name 6 US EPA ID Number ra Re <br /> FULLER EXCAVATING AND DEu0 9 81443781 <br /> s <br /> 7 Transport,2 Company Name 8 US EPA ID Number <br /> r <br /> I 10 USEPAIDNumb, <br /> 255 PARR BLVD <br /> RICHMOND, CA 94801 CAD 0 0 9 4 6 6 3 9 2 <br /> Pr dlD Number) 12 Co. I3 Total Id Unl ' <br /> No <br /> a T Quanory Wt/Val 1 1 <br /> Non-RCRA hazardous waste solid TP P <br /> G 0 loll 1 112101010 <br /> t N b Maw"I <br /> t <br /> i E <br /> r R . <br /> i A <br /> > T <br /> R a. <br /> / <br /> 1-. g Ha .ng , m its <br /> ITZ <br /> e , <br /> L <br /> Number: Stockton Service Station <br /> 24 Hour Emergency Contact. �y k � N� LC 06981./ ERG <br /> 16 GENERATORS <br /> labeled CERTIFICATION <br /> ICA IONin oilaron+by d„clarsrtholr w.d.non fer rmans onU b h ohwae accordingseta a telymble international.aid mnonal r overarm ent rdegulo�onalied packed <br /> pec Papa P° Y R Y PPII' 9 <br /> J <br /> If I our a large queen ge.aroter I certify that I ho.e^propram m ploy to educe the rda.and bx¢.ry of wosN genewtad b the degree 1 how determined b be aconomaallt' <br /> I If I..cr la aid that I ham amona,selechd the Practicable I h method of treat... e to"' or disposal currently a.adabla N me whah....mrzm the pnwnt and fibre duvet ne human health <br /> 7 ce the am.ran.1 OR .11 our a+mall"tainty gerrowfor,q"made a pond fa.1h effort b....mise my..he generation and select tlse best vena.management method.hot n <br /> id ncal.66 b no and that I can afford <br /> PrwM1d/Typed Nam S.grabrp Month Doy Year <br /> t404I tet_ FDR. 76sc..o o a G o <br /> Y T 17 Trans r I A.Imuni,limigansid of Receipt of MoNrmis <br /> Y A Prmted/TypW Nome S.gnobra Montl. Doy Year <br /> £ N <br /> ? A IS Trans r 2 Acbww ement of R . of Maternal. <br /> y L <br /> Pr <br /> �eC th Day Year <br /> At R <br /> 19 Dsswpanry Ird.colan Space <br /> Z E <br /> A <br /> c <br /> I <br /> L <br /> 1 20 Foab Wnu err O ,aler Cerehmtion d rocs. t of hozardom mabnals comrod b Iha mamfast exc t oa noted m Item 19 <br /> mbd/TYWd Name S.gnaNre Month Day Yeor <br /> DO NOT WRITE BELOW THIS LINE <br /> glue GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS <br /> DISC 0022A 11/99) Te P O Box ADD Sacramento CA 95812 0400 <br /> EPA 00-22 <br />