|
'Tens
<br />FORM #FS-UHWM
<br />(EXPIRATION DATE 9-30-98)
<br />UNIFORM HAZARDOUS
<br />21. Generator's US EPA ID No. Manifest Document No.
<br />22. Page
<br />Information in the shaded
<br />areas is not required by Federal
<br />WASTE MANIFEST
<br />law.
<br />(Continuation Sheet)
<br />C A A 1 1 1 0 0 1 0 4 4 4 6 1 7 6
<br />3 of
<br />23. Generator's Name
<br />L. State Manifest Document Number
<br />SAH JOAOVIX C006TI
<br />M. State Generator's ID
<br />1810 a )(AZIEr of
<br />STCCf.TOX, m 95201 ATTR, ALIS6X HUDS X
<br />24. Transporter n a e(289)44AA ID Number
<br />N. State Transporters ID
<br />O. Transporter's Phone
<br />26, Transporter Company Name 27. US EPA ID Number
<br />P. State Transporter's ID
<br />O. Transporters 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 />Unit
<br />Waste No.
<br />N
<br />No. I Type
<br />Quantity
<br />WWoI
<br />a.
<br />incl RT SOLID, X. o. S., 5.1, IDB479, W II, (lab -peek),
<br />(nog, 140), (pft 698402)
<br />XA
<br />XA
<br />b.
<br />CHLCRI®1, 2.3, 0X1017, (Inhalation Hazard Sans X). 4ac98
<br />1141, Wf; 769884)
<br />fL
<br />A6
<br />O'
<br />PLAI4QjHL8 SOLIDS, OPAAKIC, H.O.S., 4.1, 061326, PO 11,
<br />(Roofing race, Adbmivaa), (acg. 133), (pft 744521)
<br />XA
<br />10(
<br />0
<br />d.
<br />prRni Onjill , y igifl PiI, 2.1, 061075, (acg: 115), (1
<br />E
<br />N
<br />744632)
<br />XMP
<br />E
<br />XA
<br />R
<br />A
<br />e'
<br />fOX6e, 4.1, l9 i26, % II, (acg: 133), (pf1 744776)
<br />T
<br />wk
<br />O
<br />R
<br />WL
<br />f'
<br />80 PESTiCIDEB, SOLID, TmI1C, X.O.S., 6.1, g111122588, PO II,
<br />(2.4-d i durabaW , (acga 151), of; 744523)
<br />XA
<br />a I
<br />PiXA
<br />9
<br />2LAbli SOLD74, OBIS C, X.O.S., 4.1, 091.325, PO II,
<br />(Reefing tris, Aissivaal. (ergs 133). (pfn 744521)
<br />XA
<br />�; d k
<br />XA
<br />h.
<br />RR PE4TICIMS, SOLID, TCKZC, X.O.S., 6.1, iS2588, 1+0 11,
<br />(m;gt 151), (pf, 7441
<br />XA
<br />XA
<br />I.
<br />S. Additional Descriptions for Materials Listed Above
<br />T. Handling Codes for Wastes Listed Above
<br />* 3SA: 698402 ; (11!30) ** 3881 769884 ; (1a ba) ** 38C1 744521 )
<br />(2az1b) ** 3SD: 744532 ; (1X55) ** 38X: 744776 7 (1a5) ** 3SP: 744523
<br />(1X 1B) ** 3801 744521 ; 2 a Cf ** 381i, 744623 i 1 a CP +
<br />32. Special Handling Instructions and Additional Information
<br />Xear appropriate PPS when handling haaerdane matecaila. Nanta ie AMA ea.Wt pec 40 CM 261. A(b)(1)
<br />eaclueion. "a packed a000cding to 49 CPR. 173.12b. Job 01483-05526 Sita, 7850 South RA Bcidgefocd St.
<br />Stockton CA 95206. / ERG Guide 140 , 124 , 133 , 115 , 151
<br />33, Transporter Acknowledgement of Receipt of Materials
<br />Date
<br />APrinted/Typed
<br />Name
<br />Signature
<br />Month Day Year
<br />N
<br />S
<br />P
<br />a
<br />34. Transporter _ Acknowledgement of Receipt of Materials
<br />Date
<br />Printed/Typed Name
<br />Signature
<br />Month Day Year
<br />E
<br />R
<br />F 35. Discrepancy Indication Space
<br />c5;�
<br />leLI er fro,. feve,Qarvs.
<br />T
<br />Y
<br />
|