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Po <br />IL <br />366145-17 <br />Plmvmegnr,,.x rcnm„lxlnned for use on efile 024ddh) MwwliteC) <br />2634023 <br />FortnApproved, OMB NO.2050-0039 <br />EPA Form 8700 - (Rev. 3-05) P ' s ed' s are bbsdete. <br />I ILI ATION STATE (IF REQUIRED) <br />UNIFORM HAZARDOUS 1'�"�8t0f�Nwnbw <br />2Pageld <br />3. FinagencyRespmsePMne <br />0.Akdfest TaWng Number <br />DAT <br />WASTE MANIFEST CAI4 p pbb <br />1 <br />fA773 577-7661000163085 <br />5: Genxatoys Nate and MaTngAddress GerearoysS3eAtlWess (dddferent bun maiagaddress) <br />SAN JOAOUIR CO. PUBLIC YORKS - ORIGIN: STOCKTON PHHRCF SAN JOAOUIR CO. PUILIC VORKS DEPUSTOCKTON PHHYCF <br />1910 EAST H.AZELTON AVENUE 1056 R.A. DRIDGEFORD STREET <br />yys ptpna: T f, DN 4579 914 -30fi .TON .I) 5 <br />6.Rga5pplerl CormpanyName US. EPAID Number <br />21st Centuru rvir ren` Ma aaeme f 0 f . I P mann I 7 <br />' <br />7. Tramputer2CaaWeny U.S. EPA ID Numbs <br />B. Designated Fa3y'Name and SnsAddress US, FPA ID Number <br />GEN RIL4CNO CDRDOVA LLC ON PSC ENYIRUMENTRL SERVICES <br />11855 Yhite Rack Road <br />FaaNsPhone: RANCHO CORDOVA. CA 45712 B 31 351-0993 CAD99ORB4103 <br />.9a <br />9D.US.DOTDesatptim M*xdeg Pwff%i*v Namo,Ha=dClm,iDNurbec <br />10.Cmiarteva <br />tf.Toml <br />12Urd <br />13. Waste Codes <br />No. <br />TWO <br />HM <br />and Padkoc3coW(daM)) <br />OuanS/ <br />WtNul- <br />1• UH3080 SELF -HEATING, SOLID, OREA4IC, N.O.S. (SODIM HYDROSULFITE, <br />612 <br />X <br />CHARCOAL) 4.2 P6II <br />, <br />DF <br />, <br />P <br />w <br />2 M1S50 AEROSOLS (PEPPER SPP.AY) 2.1 <br />612 <br />X <br />DF <br />5 <br />P <br />3- NON-RCRR NRZARDDUS PASTE, LIOUID MMUTOR AIL, WATER) <br />612 <br />X <br />D15 <br />7�LI�— <br />P <br />a <br />14. Speod NaMeng bubudons and AddtlaW Information <br />(1) S)CID190 -OO - ERWI35) SPONTA1uOUSLY COKHS 121 S)CHHVZI1-RD ER6(126) PEPPER SPRAY (3) 53CHHY14D-03 - OIL FOR <br />RECYCLERLL URSTE IS EXEMPT HOUSEHOLD HAZARDOUS PASTE PER 40026).4b. <br />15. GENERATOR'S/OFFERORS CERTIFICATION: I haebydetlae that the contents dlhis mns)gnmenlae*and amaatey described above by the popw sleppngrame, ad we dass&ed, padage4 <br />marked and labdadV2wded, and are in an respects In propermrdboa for ba espodacco*91oapplicehle IntematiaWandrafmal gmemmenulregulatimalf export shlpmentand I amfhe Pdmvy <br />Exporter. lrerfiy Uutthe omtents of tliu coasgrerientconMm b Ne temndthe alladud EPAAdmowledgmeM dConsed <br />Icef*thatUewasWmWrtizA5msmteme Ikkn Win4OCFR2622'T(a)(d Iamatagequ INygereraM w(b)(dlama waliquaitygenerator)fsbue. <br />Gana21011 MrIs PMWcnyped Name 54na n Month Day Year <br />—+ <br />F— <br />16.Idemationel Std <br />❑lmpatm US. ❑E1¢ortgorn US.04!Portden lent <br />Z <br />TaasPods, so b.(for expretsa ,,* I Date <br />TnrttppperAdaioxledyn¢r4dRw*ofMotoriak <br />Traspmer l Pmtmffv ed NameSI <br />rmaae <br />Month Day Year <br />O <br />rail <br />✓t S C—x <br />,� (.� <br />2.C <br />Q <br />Tanspoder2 F'mkUfypetl Name Soatum Mamh Day Y <br />F <br />/S:Darrepaniy - <br />Ms. D"6aeperwybr&WtimSpace ❑ <br />[]Type El Residue El pedal Rejection ❑Ful Rejection <br />Mardest Reference Number. <br />i8b.Aflemafe Fao9y(orCweak4 U.S. EPAID Number <br />U <br />Ya- <br />Faddyxs F.: <br />,W <br />1e6 SgnatuadMmiale Fecdnytwe vaneator) Month Day Year <br />Q <br />Z <br />19.Har_ardousWaste Rlepel Maagement Mednd Codosfla,codes forharmdon wage baffimmt, dsspoem, and reuydugsyslems <br />0 <br />1. <br />v <br />2D.Desgnated Fac9tyOnexorOpaatm Catf=ono(MC ldhuad=MterWsmvamd byftmWnj=p4 nded ml&m lea <br />"I ypetl Name <br />Mon Day_ Year94 <br />EPA Form 8700 - (Rev. 3-05) P ' s ed' s are bbsdete. <br />I ILI ATION STATE (IF REQUIRED) <br />