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Teris� <br />FORM #FS-UHWM <br />(EXPIRATION DATE 9-30-98) <br />UNIFORM HAZARDOUS <br />Generator's US EPA ID No. Manifest Document No. <br />22. Page <br />Information in the shaded <br />WASTE MANIFEST <br />121. <br />areas is not required by Federal <br />(Continuation Sheet) <br />C A a 1 1 1 0 6 0 8 0 8 1 2 1 E S <br />2 nt 2 <br />law. <br />23. Generator's Name gran JOAQUX9 CWaerfs <br />L. State Manifest Document Number <br />RAMMY s LAL@PIIS- 1210 E. MA ,TEXT <br />(3122340964 <br />17724 MST HAM= IA STOCETON, CA 95201 <br />M. State Generator's ID <br />:ADI, CA 95240 ATTK: AIT6i9A 4I0RE'W9 <br />2041887-3 ge (209)468-3066 <br />24. Transporter Company Name 25. US EPA ID Number <br />N. State Transporter's ID <br />O. Transporters Phone <br />26. Transporter_ Company Name 27. US EPA ID Number <br />P. State Transporter's ID <br />O. Transporter's Phone <br />29. Containers <br />30, <br />31. <br />R. <br />28. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) <br />Total <br />Urai4 <br />Waste No. <br />No. Type <br />puanti <br />W I <br />a, <br />COMX/DIT?, OFF -D, V%ftro als}(Liaitss ()1.1M�]tltyt, <br />r <br />0007-5'-' <br />Y <br />NN <br />b. <br />MINT RWATED MATERIAL, 3, MO.263, PG II, (E-11624), (" qr <br />. <br />za), cpz: C61419I1t <br />L3T <br />X <br />1 <br />C r <br />0 I J' <br />C. <br />ai."J.Z FFPS'3.1•wTF.EnS.,..A.3....+207+2?�PC+"L4-Ls-.(x?A.... <br />n1.2 <br />G <br />d. <br />�S07�Ib.-N•.OTfl.--5-1..=]l�rl47.g..-J?3 •• --aak1 . <br />N <br />E <br />n -7 <br />t- <br />RA <br />A <br />A <br />a. <br />_ ZSAui-.z.TWSC.,_C77aP:iS3YE._.1P,,.O.S..._8.1... ..-731i9098r•nG <br />T <br />[: (—g: 14DF . (p£: F,994e2} 11 <br />O <br />I. <br />ISSTICIUMS. <br />SOLID, TOXIC, N,O.S., 6.1. 0252588. ➢.q _T (e=]r2: <br />769622) <br />m <br />6i 2 <br />9 <br />CTROT.0,11 IOASEB. LIQVZT. . , M _. fa=gi 11 , p..:. <br />44532) <br />f <br />VIr <br />rF <br />It. <br />;i?�( -'lUe= L)M1'I,' ,--AAV-15,Wc- <br />i. <br />S. Additional Descriptions for Materials Listed Above <br />T. Handling Codes for Wastes Listed Above <br />* BBA: 744522 *= 269: Pri +* 28C: 744493 *= 280, 698402 *, 28E: <br />698402 ** 28Pv 744523 ** 299t 744532 * <br />32. Special Handling Instructions and Additional Information <br />;vmaz al pv.opri_to T`PY` n$a:r hvncil-i:�g x.ATt, g:ar. Ai: rffi`r., <br />PRE ft6R {3A dl Angt hzMaY30li6 RM4 6]CeLL, t fp40 •:P? <br />261.4(b) (1) to 49 CPA '7.'4.I2t. .ri 1483- 0£359 <br />i£tR' <br />T <br />33. Transporter Acknowledgement of Receipt of Materials <br />Date <br />R <br />PrintedfTyped Name - <br />Signature <br />Month Day Year <br />NS <br />P <br />!; <br />°n <br />34. Transporter Acknowledgement of Receipt of Materials iS� �. --��� .- c;: ;��, <br />Date <br />R <br />PrintedlTyped Name <br />Signature `It <br />Month Day Year <br />35. Discrepancy Indication Space <br />A <br />C <br />I <br />L <br />i <br />V <br />