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State of CaNfomio—bwironmMd Protection Agency <br /> Form ApprcKvd OMB No.2050-0039(Expires 9-3496) See Instructions On back Of page b. Deportmentof Toxic Substances Control <br /> Please prim or type. form designed for use on elite(12-pih ewriter. Socromento,California <br /> UNIFORM HAZARDOUS Generator's US EPA ID No. Manifest Docum o. 2. Page 1 Information in the shaded areas <br /> is not required by Federal law. <br /> WASTE MANIFEST 11 of I TkTMP CA93TEMP <br /> C 3. Generator's Name and Mailing Address r _ �}Q 1 f e^ Suede Marlifast DQeatsretM Nva> r <br /> h �ft'Yr �'' u4A . v 7 '�/,Vlz955 77 <br /> �0- ,g� d f �s o 11 g �r s a 3 3 3 y £, !�1�.�, S IL Sty,�erafar•s ID <br /> mx.eerier �s Phans ) <br /> S. Transporter 1 Company Name 6/US EPA-ID Number G Slate T . s <br /> a0 <br /> D.Ttaniporter's Phone <br /> J <br /> -' ronsporter 2 Comporry Name 8. US EPA ID Number E:State Traraporter's <br /> Q <br /> V <br /> �. P, Uartspartar's Phone <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number G. State Faci6 ys ID <br /> a ERICKSON INC. <br /> V 259 PARR BLVD. H. FaciWs Phane <br /> T) a <br /> RICHMOND, CA 94801 C AlDI 01019141616131912 f510) 238 - 1393 <br /> 7 U 12. Containers 13. Total 14. Unit <br /> Z 11. US DOT Description(usctudinq Proper Shipping Name,Hazard Class,and ID Number) <br /> 7 _ No. Type Quantity Wt/Vol 1. Waab Nssmdw <br /> NON-RCRA HAZARDOUS WASTE SOLID: WASTE Siam 512 <br /> 3 EMPTY STORAGE TAMC <br /> N E ERG R DONE 12 P P NOW <br /> EPA/Otbet <br /> G <br /> coo N b. `.state <br /> G E <br /> C4 R EPA/01her' <br /> v <br /> A „r <br /> T <br /> C. state <br /> ao 14 <br /> R EPA/Other <br /> w <br /> Z d State <br /> Z <br /> w <br /> U . <br /> EPA/0d"; <br /> N <br /> Z J. AtftiltorwY(yeu rip6orn for Fistt�ed Above y•• * r f' K. Handling Codes for Wastes fisted Above <br /> O QTY.- TV T .. <br /> rn — S'PH <br /> LU <br /> TtZ :'DRY' ' 'ERT . ; �88+RI,t t ACI <br /> J <br /> C. d <br /> a <br /> Z <br /> O 15. Special Handling Instructions and Additional Information <br /> 24 HR. EMERGENC'� CONTACT <br /> a KEEP AWRY FROM SOURCES OF IGNITION. ALWAYS WEAR NAME: C1LtY!?n_ ...� <br /> Z HARD HATS WHEN WORKING AROUND UGSTs. -�� C� <br /> F PHONE: L _ya Q��E=,�tC'24 HR. O 6. <br /> 16. GENERATOR'S C9fTIFfCATION: I hereby declare that the contenh of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> Q packed,marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> V <br /> 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 1 have determined to be <br /> economically practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future <br /> N threat to human health 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 <br /> waste m mart method that is available to me and that I can afford. <br /> O Printed/Typed Name -Q1 / DTT Signature Month Day Year <br /> U <br /> w 17. Tr t-Xc of Recei t of Materials <br /> A Printed/Typed Name Signature 1 =r Month Day Year <br /> LU <br /> N T C 7 <br /> W0 18. TroigForier 2 Acknowledoement of Receipt otdAciterials J - <br /> R Printed/Typed Name Signature Month Day Year <br /> LL T <br /> O <br /> ywj 19. Discrepancy Indication Space <br /> Q F <br /> U A <br /> Z C <br /> 1 <br /> L <br /> 1 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> T Printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A (1/95) Yellow: GENERATOR ,RETAINS <br /> EPA 8700-22 <br />