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11/20/96 09:26 '0209 467 1026 A B R INC. / Z009/009
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<br /> � �To of Colitorn:o—Ermtonmemal P.mcehpn Apeney
<br /> Form Appro•ed OMS No-7050-0039(Eaphes 9.70.94) See Instructions on bock ofPy a „ 6.
<br /> PICOWIDrins or type. Form d•.pn.•d for ore—-1-m f 11-p4,h)yp.w„er, Department of Taatc Svblitytees Cvnr•a
<br /> f. Generproi s US EDA Ip No.
<br /> UNIFORM HAZARDOUS EP/ Manifest Document No. Pope 1 Intormot:on io the shaded areas
<br /> WASTE MANIFEST �' 11 Q� is not required by Federal low,
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<br /> 3 Generator's Nome and Mailing Addreu �.� �A �+ s'�:SI f+ti pomeU u
<br /> 2325 W. •,
<br /> Charter Way - ���- �".- `�.'' :�z �:���
<br /> N Stoddon,CA 95206 j
<br /> 4 Generotoi s Phone92 y 917
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<br /> S. T vn)poner t Cow,pan,Nome '6. US EPA 10 Number +-
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<br /> BDC SERVICES INC. 1
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<br /> J 7. Transporter Z Company Nome 8. US-EPA ID Number5fa.e ;CQM_tdt-0'^
<br /> Q 9. ocil Nome and Site Ad r
<br /> Z Itis gnated F iy doss 10. US EPA ID Number rrfiF f%JICiIMp'' t
<br /> FORWARD INC. _ 'L '
<br /> 0 9999 SOUTH AUSTIN RD ; r ?�iGfj!z.PM`e -
<br /> ) z MANTECA, CA 95336 7 11 13 1
<br /> Z 11 US DOT Desg Napier Home,Hazard Gass,and 10 Number}Description(inclvdln Na Shi 17. Contairmn 13 Total Il Unit
<br /> Z No. Tipe tont,ry wt/Vol
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<br /> R.11. ASBESTOS, 9, NA2212, PG III
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<br /> O 13, Special Handling lnssrvotons and Additional Infmmation
<br /> 24 HRS. EMERGENCY 1-900-535-505--�;
<br /> z BDC SERVICES, INC. 766 SOUTH AYON AZUSA, CA 91702
<br /> W EPA REGION IX
<br /> x ESTOS REM VAC REQ REMENT 40 CFR 61 (BAGGED SEALED AND lA$ELED) .
<br /> 16. GENERATOR'S CERTIFICATION! I hereby declare that the contemn of rhes consignment are tv)ly and accurately described abo a by proper sbipprnq name and are da:ufied.
<br /> Qpocked,marked,and labeled,and are:n all re)pecr.,n proper condition for sranspors by high-ay according to applicable insernt tionol and notiowol gorornment regulations
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<br /> _- If I am o loege quantity generator.I cenify that I hate a program in place to redvice the rolvme and tavary of „.este gene ated to the degree I have detornst^94 to be
<br /> NOno—caly practicable and that I hore s..fected the
<br /> practicable rntlhvd of treormenl.)roroge,or disposol currently o•a4bbl.• o me which mmtmices the present and luivre
<br /> VI rhreor ro human health and the environment;OR, it 1 am a small Quantity generator I haro made o good faith efton to—,,-ce my waste generation and :elect the best
<br /> waste mane mens method that Is arolable to me and that I can afford _
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<br /> / y(p�ed Nome 7 Signature Month Day ! Yea,
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<br /> z17. Transporter 1 Ackno.ded emenr of Receipt of Materials -
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<br /> 1 0 Foci64y Owner or Operator Ccr"IMatiOr,o1 recei r of horordovs materials coved by this a.vmlesr except ns noted;n Item 19
<br /> T Pr:nred/Typcd Name Si,j..nhsre -- Month Dor Tow
<br /> DO NOT WRITE BELOW THIS LINE-
<br /> MSC u077A I9;v:q 4L." GFIVIRAIOR SEND•. TMH COPY TO GTSC WITHIN 70 Uali
<br /> I .:rA t7on • .. I.c-, 9-,• 100 Sr.n.::,r: - t'a ?,a1;0400
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