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ytetr�rnm nMt_Ms[sfVV3 <br /> WASTE MANIFEST it not required by Federal law <br /> � r. IAInfafPlnIPfQl'�iSJ �I���._I_!- 11 all <br /> 3. Generator's Name and Mailing Addrei Sitittt:7Apt1fleePOaatlsettt Hltnttber <br /> t Q ilar�rFCia Ut�zFIEo SCHOOL DISTRICT <br /> : �: 9,67.937: <br /> C4 .J MANTECA, CA 95338 B?W afQi. <br /> W) <br /> A. Generator's Phone <br /> O5. Tronsporter I Company Name 6. US EPA M Number tr..5�desTtvenpoited:ID.:: <br /> ALLTP11 PlETROLEUM IC JA 1L 10 IC IO 11 11 l? 12 1114 Phon,"6--2€' -576-8500 <br /> 7. Transporter 2 Company Name 8. US EPA 10 Number .! $�pp�ratpsyf( : <br /> 00 q I I I I I <br /> z 9. Designated Facility Name atnd Six Address 10. US EPA ID Number <br /> V CT Irl:0 ^.00rA,(?C <br /> row Qt; 'sr lel f)l 10-IA I^ r: <br /> 'Y . Ct n 12 17 ' <br /> ` *. <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class.and 10 Number 12. Containers - 13. Total T4. Unit - .,- <br /> Z P f g Pe PP 9 ) No. T Outs" WT/Vat I:'Way.Nornb r <br /> r a. State II <br /> 3 N11i i PCriA HAZARDOUS 'OSrc LI0',Ui 0 223 . <br /> C3 - EPA(Odrr . <br /> Q E r l T .l - nia 01 1 <br /> CW N b, 'St. <br /> E <br /> ts <br /> OA EPA/ CrNser. <br /> mT c. + I l f Stats <br /> : O <br /> R EPA/OWw <br /> LU <br /> III I <br /> Zd. State <br /> UA <br /> U 1 ! ! I I l EPA-/OMeruj <br /> _ <br /> Z J. Additional Descriptions for Materials Lived.Abtsys K„KandGnq:Codes.for Wastes Listed Above <br /> LU <br /> Q 15. Special Handns <br /> Handling Instructioand Addih*rol Information <br /> y <br /> =Ar TLTTY rC tt. A =� _ ' `C I <br /> —�—,�� <br /> 16. GENERATOR'S CERT1FKATION! I hereby declare that the contents of this consignments are fully and accurately described above by proper shipping name and are classified. <br /> Q packed,marked,and labeled,and ore in all respects in proper conditions for transport by highway according to applicable international and national government regulations. <br /> U <br /> ,r 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 /> r <br /> a economically practicable and that I have selected the practicable method of treatment, storage,,or disposal cvrremfy available to ma which minimises the present and future <br /> in threat to human health and the environment; OR, if I am a small quantity generator. I hove made a good faits effort to minimize my waste generatiom and select the best <br /> waste managemem method rhat it available to me and that I can afford. <br /> Printed/Typed Name Signature - Month Day Year <br /> 1 ` I i L•r _ f L/ <br /> Z r 17. Transporter I Acknowledgement of Receipt of Materials <br /> - - _ Mamn Day Year <br /> s Prinred(Ty Name:� P ,, //,, , I Signatom <br /> LU <br /> snorter 2 Ackr emenr of x t aF Mate els r <br /> Printed/Typed Name Signature Mornh Day Year <br /> a [ I f <br /> V)7 19. Discrepancy Indication Space c <br /> Q Is <br /> U <br /> A ' <br /> Z C F <br /> I <br /> L <br /> 1 20. Facility Owner or Operator Certification of recti t of hazardous materials covered by this manifest except as noted in Item 19. <br /> T Primed/Typed Nome Signature Moretti Day Year <br /> 7 <br /> LZ�. <br /> ran NOT WRITE aa.OW THIS UNE. <br /> 'teilow .rS0F SEND$ rHt$ COPY f0 GENERATOR WIMN 30 DAYS. <br /> ,Generators who submit hazardous waste For transport aur-of-stere <br /> DTSC W22A (1193) proauce completed COPY of this copy and send to DTSC ...rh;n 30 aoys <br /> EPA 8706-22 <br />