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NON-HAZARDOUS WASTE MANIFEST <br /> Please print or type (Form designed for use on elite(12 pitch)typewriter) <br /> Manifest 2.Page 1 <br /> 1.Generator's US EPA ID No. <br /> NON-HAZARDOUS Document No. <br /> WASTE MANIFES / <br /> T CAD9 8 0 88 6998 4022940U._;_21=..- of <br /> 3.Generator's Name and Mailing Address TRACY SENIM CEMil <br /> PACIFIC GAS & ELECTRIC CO. <br /> 502 E MM LINE IMD <br /> TRACY CA 95376 <br /> 4.Generator's Phone((925)513-4845 <br /> 5.Transporter 1 Company Name 6. US EPA ID Number A.State Transporter's ID <br /> B.Transporter 1 Phone <br /> .0niz- <br /> 7.Transporter 2 Company Name 8. US EPA ID Number C.State Transporter's ID <br /> ID.Transporter 2 Phone <br /> 9.Designated Facility Name and Site Address 10. US EPA ID Number E.State Facility's ID <br /> LMFILL <br /> 10840 PASS ROAD F.Facility's Phone <br /> LIVUOM 11 CAA .L IC A D 9 8 1 3 8 2 7 32 f=/449-6349 <br /> 11.WASTE DESCRIPTION 12. Containers 13. 14. <br /> Total Unit <br /> No. Type Quantity Wt.Nol. <br /> a. NON RROUTED MATMUAL (NON HAZARI)OUS SOIL) <br /> D T 0 0 1 8 y <br /> G b. <br /> E <br /> N <br /> E <br /> C. <br /> A <br /> T <br /> 0 <br /> d <br /> UJ . <br /> G.Additional Descriptions for Materials Listed Above H.Handling Codes for Wastes Listed Above <br /> #�7 A <br /> Cn 11a 102310CA WN SOIL <br /> D 11b <br /> 0 11C <br /> 0 lid <br /> N 15.Special Handling Instructions and Additional Information <br /> WM PRMCTIVE GUYTHING & HYBEAR <br /> 24 HOUR 877-577-2669 2020985 <br /> Z <br /> 0 ERGENCY CONTACT <br /> Z SITE I.D. 20-P <br /> ­Bjmea LV t- Jr tot U <br /> 16.GENERATOR'S CERTIFICATION:I hereby certify that the contents of this shipment are fully angkpccurately described and are in all respects + <br /> in proper condi'on for transport.The materials described on this manifest are not subject to fed-11all hazardous waste regulations. <br /> atePrinted/Typed Name Signa re Mnth eWay Par <br /> 17.Transporter 1 Acknowledgement of Receipt of Materials Date <br /> Y <br /> Signatu onth <br /> A RLIMW -Pay <br /> N ee;o:�_4x14AP <br /> A;yped Name <br /> S <br /> P Date <br /> 0 18.Transporter 2 Acknowledgement of Receipt of Materials <br /> R Printed/Typed Name Signature Month Day Year <br /> T <br /> E <br /> R <br /> 19.Discrepancy Indication Space <br /> F <br /> 1A <br /> C <br /> 20.Facility Owner or Operator;Certification of receipt of the waste materials covered by this manifest,except as noted in item 19. <br /> L F Date <br /> I <br /> T Printed/Typed Name Signature Month Day Year <br /> Y <br /> AM PRINTED ON RECYCLED PAPER <br /> CR 4 @2002 LARELAASMO (800)621-5808,www.labelmaster.com USING SOYBEAN IW <br />