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11/20/96 09:25 0209 467 1026 Q B R INC. Z007/009
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<br /> Form Apptvved OMD No.T030-0079(Expires 9-36941 See Instructions on bock of page 6. Depan,nerr of To.ic$,,bvv�ces
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<br /> UNIFORM HAZARDOUS t Generma"s US EPA ID No Manifest Docvmenr No. 2. Pape 1 Iefarmgtion in the Ihoded areas
<br /> W ASTE MANIFEST is not rtgu.ed by Federal to
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<br /> WASTE I / '• 0 9 � 1 1 „ of 1
<br /> 3. Gnneyafe:s Nome and Mail A.A. State INanllail 0ecu�itt Nsttyber -
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<br /> )t on_CA 95206 D. stile Genera ors 1DIN It :.
<br /> Generator's Phone e
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<br /> O 5. Tronspoeler I Company Name 6 US EPA 10 Number C: �t.T onset ner's ID, ,
<br /> 30C SERVICES, INC. CAG 9 8 '. [4151t., 15 tia � .rmi, arser:Pi,one
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<br /> 7 TronspoAe,2 CC-parry Nome 6. VS EPA 10 Nvmbe, 1:. Ston TMnspc rter-s ID. lt•i
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<br /> Q 9. Designated Facility Name and Site Address 10. US EPA ID Number G.Stole 1`90;ly't ID •:rJ:'�_ei�- ft, '
<br /> FORWARD INC. C R ) 19 191e 17.14-x4`11`13131
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<br /> '3399 SOUTH PUS T I N RD H. FodGys Pha,e •t.::;.r'r.'.' • . .
<br /> 7 MANTECG+, Cl;( 9533b t: A ID? fi 10 7 9 4 1 3 s i2�9398>?-=4'c98
<br /> V 12 Conloiwers 11. Total 14. Unit '
<br /> ^s 11 US OOT Description(including Proper Shipping Name.Hazard Class.and ID Nvmberl •' '
<br /> ✓z No. Type OIcintrty Wtjvol {..want,TlNlhbfli.'•
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<br /> Z J.AtidrtivTto(,fJq<T(p�ttxti"1pe stall Abwa. , 1r t lC Hall Aing Cedes for Wgstm d%Abgee
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<br /> Z 15.'Speeivl Handling Instructions,and Additional information-
<br /> O c4 HRS. EMERGENCY 1-800-535-50!,3
<br /> a PDC SERVICES, INC. 7EE SOUTH AYON AZUSA, CA 91702
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<br /> EPA REGION IX
<br /> X ASBESTOS REMOVAL REQUIREMENT 40 CFR 61 (SAGGED, SEALED AND L.ASE.LEL•)CQ� _2P I
<br /> .r 16. GENERATOR'S CERTIFICATION: I hereby declare shot the contents of this consignment are fully and occv,vkly desc%bed abo'<by proper shipping name and are doss.6d.
<br /> J pocked,marked,and labeled.and are in an rnpecns in proper condition far trampan by highway according To applicable ier_rnohonal and notional government regvlation,
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<br /> J If I am a large gvanfity genorolor, I certify that I have o program in place to rcdvee the volume and ioziciy of wase ge-mi,wed to the degree I have determined to be
<br /> economically practicable and than I have selected the proctitobte metlsod of Treatment,storage.o, d;Vosoi cv,re.8y avviloyl•to me which minimizes the present and future
<br /> 0. threat To human health and the environment;OR. If I ism quantity smallquantity
<br /> y generator, I have mode o good faith em�stlort to CC my.race generation and select the best
<br /> waste management method their is evvitable to me and that I tan afford.
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<br /> 17. T,onWarverI Acl-o..led ement of Receipt of Materials r' _-
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<br /> 0 18. Tans rta?Acka*wlr0 emenl qt Recei i of Metalob
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<br /> I 70, Faoli 0. ,er e,Operator Cernficor•o-of,eceip!of hazardous materials covored by this manifest e.cepT as noted it Item19
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<br /> DO NOT WRITE BELOW THIS LINE.
<br /> •_I rrt stn tort ntn US 11ua CUf V Tp OT5C- W11HIN 'is, 11AY•,
<br /> 015C E077A 0,931 CA 9581704(1,)
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