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11/20/96 09:24 $249 467 1026 Q B R INC. f�0oS-009 <br /> •r+e.2050-0039(Expires 9 30-94) See Instructions on back of F 6. DepartmeaT of Toxic Subaoncet Con''. <br /> Form deigned for use on ehre(12p;lch)type—rer. 30tea w cohfornie <br /> 1• Generator's US EPA ID No. Manifest Document No. Page 1 nformation in the shaded areas <br /> UNIFORM HAZARDOUS <br /> s not required by Federal low. <br /> WASTE MANIFEST '- �; 0101/ ;.) 011 0 9 0 ! `a of I <br /> 3. �ns�t 3''s Nome f��d Mailing Address A Mo if tsl lDacvmcssf Nu,n r, <br /> s 'DL/ // f ' r <br /> 1 J "v�7�Jt{/ /•t ilJa �r6 r ,' ��, �i t ' uM�i <br /> y 4i 1optY tai,}t'f 9���'. F 1T4"-� r tA... i <br /> CV C gyp 4. Generator's Phone {7 ) <br /> 'is'- ►l <br /> enerti. <br /> oo <br /> d 5. Transporter 1 Company Nome 6. US EPA ID Number <br /> t S t r"1 t :`St r lh t•',ifirl: <br /> HDC SERVICES, INC. I 1 + r a ',' <br /> 7 Transporter 2 Company Nam. S. US EPA ID Number <br /> a Q I 9. Designated Facility Nome a,d Slte Addrei, 10. US EPA ID Number <br /> Z i <br /> ff FORwAPL IMC. 14, p � '� �7,t�. 14 <br /> �`'''1�n <br /> 1991 SQU rH MUST IN RF) <br /> MANTECA, C�) -.15--,36 17 _j il 1 <br /> 11, US DOT Description(mcludin12 Containers 3. Total 14 Unitp Proper Shipping Name,Hazard Clo::,and ID Number) <br /> Z_ No. r _Dvanhry wr/Vvl <br /> !� Y a. SIM1,.,.�., <br /> 77 3 G R.Q. ASSES rOS, '3t AJGec�1 L'tr 7 1 i i:bVly} <br /> �t I EPA'/Offr• <br /> E Q V t 1� t ''Ir"''•l� '1';�i":�s-s�•%iti <br /> 00 N b. <br /> ao E <br /> N! ft FPA/Other�tijl;: :u. <br /> •t i A L • <br /> T i c. Stoto f k: <br /> m. O p t <br /> oC fl I EPA/Ofhe�tYZl >, <br /> w 1, <br /> Z <br /> U! <br /> OZ J��pi�d aq°i,Ui!q�*ont Tpi'M rigls GstediAbgr!', K,°Rebdllnq r:r dot,foi wasros lifted Above 6`u ,ry <br /> CA.4 <br /> FOIRINTW REMJLATED WSTE ONLY 03 b. <br /> Ln <br /> d. <br /> Z Special Hondlin Instruawns and Additional Infermo6on <br /> Q g 24 HRS. EMERGENCt 1 -800-535-5053 <br /> Q SDC SERVICES. INC. 766 SOUTH t=1rEIIV PZUSA, CIA 9170 ' <br /> Z <br /> w EPA REGION IX <br /> ASBESTOS REMOVAL REQUIREMENT 4,0 i_:FR 61 (BIAGGED, cSEk=il_ED 4IND <br /> 16 GENERATOR'S CERTIFICATION, I hereby dod9ro?hof the contents of this com-ignment ore fully and accurately denc,bed obo,e by proper shipping name and are classified, <br /> J <br /> packed.marked,and labeled.and ore�n all res c%m ro per condlt;on for von ort b h� hW ocw,di to 0 <br /> Q j D Pe P P W Y g oT' n0 Pplicoblc innerrorienol orad noK*no l government regulations <br /> V <br /> If I am a large quantity generator, I certify That I hove 0 program in place to reduce the volume and totticity of .caste 9trerated to the degree I hove determ-ned to be <br /> economically practicable and that I have selected The prooicobk modwd of treatment,storage,or disposal currently avoilok-h to me which minimizes the present and future <br /> a 1 threat to human health and the en—onment,OR, d 1 am a :moll quo—y genemlor. I have mode a good faith effort To my avtc gontrotion and seNH The best <br /> waste management method that is available to me and rhat I can afford _ <br /> a 1 Printed/Typed Name Signature J Month Day Year <br /> 0 ' J 1/ _ rC rC J <br /> Z c 17. Transporter 1 Acknowlod oment of Recu t of Matenals <br /> ww Pr rated/T ped Na S g a?um/ Month Day Year <br /> W �� jf Wil. -� �f~ 1.� <br /> �{ 0 r 18. TranspimMer 2 Acknowtedgemom of Recti r of Material, _ <br /> T Panted/T <br /> T yped Name 5 gnotvrc Month Day Year <br /> 0 e <br /> w 19, Discreponey Indication Sp- <br /> 0 <br /> Q F <br /> V A <br /> Z I <br /> L <br /> 120. Facility Owner or O eraror Cereficarion of receipt of hozordous materiab covered by this monifest except as noted in item 15'_ <br /> T Printed/Typed Nome S;gnatvre Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 9072A (9/93) Ye�'ov. GENFPATQP RFTAINS <br /> EPA 8700-22 <br />