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<br />FORM #FS-UHWM
<br />(EXPIRATION DATE 9-30-98)
<br />UNIFORM HAZARDOUS
<br />21. Generator's US EPA °! Manifest Document No.
<br />22. Page
<br />Information in the shaded
<br />WASTE MANIFEST
<br />,ity�
<br />areas is not required by Federal
<br />(Continuation Sheet)
<br />(
<br />C A H 1 1 1 0 0 ��T7 6 9 2 6 2
<br />law.
<br />23. Generator's Name
<br />L. State Manifest Document Number
<br />COU"T Or SAN JOAQUIN
<br />1810 C. HAZELTONM.
<br />R�/ HuD,fryN
<br />State enera or's ID
<br />sracK 'ON, at 95202 ATrw.
<br />(209)468-3066 ( -3o6b
<br />24. Transporter Company Name 25. US EPA ID Number
<br />N. State Transporter's ID
<br />O. Transporter's 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 />No. I Type
<br />Total
<br />Quantity
<br />Unit
<br />Wt/Vol
<br />Waste No.
<br />a.
<br />r
<br />N OT N)
<br />-a-b.
<br />c
<br />sWR
<br />°
<br />STIC ALKALI LIQUIDS, M.O.S., 8, 081719, PG II, (Sod UUM
<br />Ilydroxide, Ammonia), (erg: 154) , (p!: 744525)
<br />I
<br />ej OS
<br />F
<br />UO 2
<br />P
<br />M R
<br />o
<br />d.
<br />NIUK NITRATE EZRTILIZERS, 9, 0112071, PG III, (erg: 14
<br />)
<br />E
<br />p£: 744493)
<br />E
<br />003
<br />D F
<br />Ioo3q9
<br />P
<br />NR
<br />R
<br />A
<br />e.
<br />CORROSIVE LIQUID, ACIDIC, INORGANIC, N.O.S., 8, 083264, PC
<br />T
<br />I, (Hydrochloric acid, Phosphoric Acid), (erg: 154), (p!
<br />°
<br />R
<br />9884)
<br />OOLI
<br />D F
<br />O cc 2
<br />P
<br />N/R
<br />T_CADSTIC
<br />ALWILI LIQUIDS, N.O.S., 8, UN1719, PG II,
<br />Lab -pack), (erg: 154), (pf: 769885)
<br />3
<br />F
<br />oO29O
<br />P
<br />N R
<br />9
<br />XIDIZING SOLID, CORROSIVE,N.O.S, 5.1, ON3098, PG 1I,
<br />Lab -pack), (erg: 140), (pf: 698402)
<br />OOL
<br />F
<br />OI -1
<br />P
<br />NIR
<br />hCXIDIZING
<br />SOLID, TOXIC, B.O.S., 5.1, UN3087, PG II,
<br />Labpack), (erg: 141), (p!: 744604)
<br />001
<br />D F
<br />c)ooqqP
<br />NR
<br />L
<br />CORROSIVE LIQUID, ACIDIC, INORGANIC, N.O.S., 8, UN3264,
<br />I, (Lab -pack). (erg: 154), (pf: 744524)
<br />00Q go
<br />01-
<br />D F
<br />P
<br />N/R
<br />S. Additional Descriptions for Materials listed Above
<br />T. Handling Codes for Wastes Listed Above
<br />*zwc +^—{1Uo?S��QPcI) ** 9-(,uoTsk,rfad) ** 28C: 744525
<br />76988) +*
<br />($+cfSbP ) ** 28D: 744493 is
<br />28G®698402*(LE:
<br />** 28r: 769885 (3X 50 DP ) Of 28H:744)
<br />4
<br />( lXaoDe 1 ** 281: 744524 ( -LX -CS- AO )
<br />32. Special Handling Instructions and Additional Information
<br />Sob 4 1483-04811
<br />Waste is RCRA exempt per 40 CFR 261.4(b)(1) exclusion. Use proper PPE when handling hazardous
<br />materials. / ERG Guide 127 , 128 , 154 , 140 141
<br />33. Transporter Acknowledgement of Receipt of Materials
<br />Date
<br />APrinted/Typed
<br />Name
<br />Signature
<br />Month Day Year
<br />s
<br />34. Transporter _Acknowledgement of Receipt of Matedals
<br />Date
<br />E
<br />Printed/Typed Name
<br />Signature
<br />Month Day Year
<br />R
<br />35. Discrepancy Indication Space
<br />A
<br />c
<br />I
<br />L
<br />T
<br />r
<br />
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