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of Protection Agency - <br /> 0-0039(Expires9-30-94) �`� See Instructions on,back of --ne 6. Department of Toxic Substances Cont t , <br /> ffesigned for aTe on elle(I2pirc6 �.: �. - - "ti Sacramento,California _ <br /> ORM HAZARDOUS enerotoes US EPA ID No. .Manifest Document No. 2. Page 1 Information in the shaded areas <br /> ;WASTE MANIFEST � � � <br /> 4 1 8 2 1 of 1 is not required by Federal law. <br /> er�t,,%Ndgtetapd jailing Address A. State manifest Document Number ^ <br /> ul ..f <br /> -7 <br /> /4. <br /> CA .�5'20, 6. State Generator's ID <br /> Generator's Phone ) � �L O /� (9 � � �1 14!:)j2 / r <br /> 5. Transporter 1 Company Name b. US EPA ID Number C. State Transporter's IDS <br /> BDC SERVICES, INC. C A D 9 8 1 4 5 5 5 2 0 D. Transporter's Phone ++0 1Z'-• fig—104 <br /> 7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID 1' <br /> IU11 <br /> Transporter's Phone �+ <br /> 1-6. <br /> ____...----._ -------- <br /> 9. State Facility's ID <br /> cili and Site Address l0. US EPA ID Number <br /> 11Z �F�� CAD �? 9073111 3 <br /> �p oil <br /> 9999 SOUTH AUSTIN RD { <br /> --j!L MANTECA, CA 95336 C A D 9 9 0 7 9 4 1 3 3 H. Facility's Phone .(209)982-4297 <br /> �a <br /> U _ 12. Containers 13. Total 14. Unit <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) <br /> ^^Z No. Type Quantity Wt/Vol I. Waste Number . <br /> - <br /> ~ q`R.Q." HAZARDOUS SUBSTANCE SOLID N.O.S. ORM-E State f.5. <br /> 3 G NA 9188 (ASBESTOS) 7 EPA/other <br /> o E T <br /> a0 N b• .. - State <br /> ao E <br /> N R t/ EPA/Other <br /> v A _ <br /> T C.00 <br /> state <br /> O <br /> R EPA/Other ' <br /> LU ...� <br /> ~ d. State <br /> Z lLU <br /> U <br /> EPA/Other <br /> Z <br /> iI( f rl'_ift fat �'iCs Sz�. tiCl = <br /> a. <br /> �S 1R N GR -f.f�A I�,Sr OP rA(-TON ONLY WASTF ONO <br /> Is:iLL I !f-'OTRAf':"' 1-800-535-5053 <br /> �l HFIS. F t. PAY, 7 DAYS PER 14EF#` <br /> 0 15. c'al <br /> a VPGons iGd.dit�nal Intmn <br /> 66 §'rO. A <br /> VON AZUSA, CA 91702 l <br /> Z <br /> Lu ASBESTOS REMOVAL REQUIREMENT 40 CFR 61 (BAGGED, SEALb & LABELED) <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of the consignment are fully and accurately described above by proper shipping name and are classified, <br /> J <br /> packed,marked,and labeled,and are in all res m proper condition for transport b highway according to applicable federal,state and international laws. <br /> U P Pits P Pe Po Y 9 aY ^9 PP <br /> y . . <br /> If 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 determined to be <br /> economically practicable and that I have'selected the practicable method a storage,or disposal currently available to me which minimizes the present and future <br /> threat to human hes and the environment;OR,S 1 am a CL small quan generator, I ve mode,9 g a effort t minimize m waste generation and select the best <br /> C <br /> waste ana thod that is available to me and that I can offori. <br /> Q Print ped me sign re onto _Day =Year, <br /> Z . Tra 6 iter 1 Ac mowled ement of Receipt of Materials <br /> LLJ Pri� /T ped Name Signa ,�� Mo �Dea� <br /> -- - Ll7L. <br /> s <br /> 0 18:�Trap(porter2 Acknowledgement of Receipt of Materials <br /> w T Printed/Typed Name Signature Month Day Year r <br /> U- E <br /> O R <br /> Y <br /> N19. Discrepancy Indication Space <br /> U FA Q�jC <br /> Z C <br /> I <br /> L <br /> 1 20. Facility Owner or Operator Certification of receipt of hazardous mat i s covered by this manifest except as noted in Item 19. j <br /> T Printed/Typed me Sig re Month Day Year <br /> 1 <br /> DO NOT WRITE BELOW THIS LINE. <br /> Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. <br /> DTSC 8022A (7/92) (Generators who submit hazardous waste for transport out-of-state, <br /> EPA 8700-22 produce completed copy of this copy and send to DTSC within 30 days.) <br />