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-.ection Agency <br /> J039(Expires 9-30-99) See Instructions on back of page 6. Department oFT cic Subst1Vces�ontrol <br /> .ad designed for use on elite(1'2 pitch)types' er. Sacrame to,Californiaa// <br /> 1. ;ator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the sha ens <br /> UNIFORM HAZARDOUS snot required by Federal law. <br /> WASTE MANIFEST <br /> 3. Generator's Name and Mailing Address A. State Manifest Document Number <br /> CHER h U-(- LANE B. State Generator's ID <br /> LOA. Generator's Phone ( .. ) �,, , <br /> N 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID[Reserved.] <br /> LO <br /> 7 CD. Transporter's Phone <br /> A e ( , _9 it j <br /> 6 - 1O r1 1 1211 Tr <br /> ao 7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID[Reserved.] <br /> J F. Transporter's Phone <br /> U 9. Designated Facility Name and Site Addres 10. US EPA ID Number G. State Facility's ID <br /> R 11 C R1 :� (r ra k, f Sy <br /> Z i�.`>i Z;IAS(' PIC0 1,L.VV _ H. Facility's Phone <br /> p t.�l`,:� ANGELES, CA 9(,M,2' f A t_t Qt i"1 6 L L 4 0 C, (It��) <br /> � 12. Containers 13. Tocol 14. Unit <br /> Q 11. US DOT Description(including Proper Shi ping Name,Hazard Class,and ID Number) No. Type Quantity Wt/Vol I. Waste Number <br /> U <br /> f State <br /> �= Re. WAST E. PA'INf Fit.C� '(J L.A1'] Ipil{{'t'r}'v.d.AL 3s UNI-,"E <br /> EPA/Other <br /> State <br /> o N b' <br /> 0 E EPA/Other <br /> v R <br /> CN A state <br /> C. <br /> 0 EPA/Other <br /> co <br /> R State <br /> LU d. <br /> Z EPA/Other <br /> w <br /> U <br /> LU K. Handling Codes for Wastes Listed Above <br /> N J. Additional Descriptions for Materials Listed hove <br /> Z a. 6. <br /> LU ADD Iw PA ).CID t f1�a 3. �15 c. d. <br /> J <br /> Q <br /> Z 15. Special Handling Instructions and Additio al Information p <br /> 0 P g ..t.f7 1 hi17i 'f it C7 <br /> Q GLC)t.•ES" ( i7 faLr i f F2Lj�'t'I <br /> Z 1;�41wF(C;F ftiG't` t:'C3f T I C T: C:H !4 iR C <br /> 16. GENERATOR'S CERTIFICATION: I hereby eclare that the contents of this consignment are Fully and accurately described above by proper shipping name and are classified,pace , <br /> Q marked,and labeled,and are in all resp is in proper condition for transport by highway according to applicable international and national government regulations. <br /> U <br /> IF I am a large quantiy generator,I cerfi that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economicaIt <br /> N practicable and that I have selected the p acticable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a small quantity generator;I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> Oavailable to me and that I can afford. <br /> } P ted/Typed Namenature t t Month pay Year <br /> ZFes,t^] t: t�i t,V' <br /> wT 17. Trans offer 1 Acknowled ement of ecei of Materialst <br /> Mronth Day. Yea <br /> LU <br /> p Prin e T eGI Name r Sig atu j :, 7 / i ( ill <br /> LL LU 0 18. Traris orter 2 Acknowledgement of Recei of Materials / / <br /> 0 R ignatura Month Day Year <br /> --7 <br /> T Printed/Typed Name <br /> LU E <br /> N R <br /> U 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> I <br /> L <br /> f 20. Faci ity Owner or Operator Certification o receipt of hazardous materials covered by this manifest except as noted in Item 19. Month Day Year <br /> I Printed/Typed Name Signature <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A (1/99) Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br />