Laserfiche WebLink
Arkansas Department of Environmental Quality <br /> Hazardous Waste Olksion <br /> P.O. Box 8913, Litt ock,AR 72219-8913 <br /> *� Telephone: (501) 682-0833 <br /> Please print or type. (Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator's US EPA ID No. �01 <br /> Manifest 2.Page 1 Information in the shaded areas is not <br /> Document No. required by Federal law. <br /> WASTE MANIFEST C 0 7 4f 6 4 2 2 8 2 2 of 1 <br /> 3.Generator's Nami3 and Mailing Address A ta(8 hggh tfytpoc�tmdnttoo-t T-&'2-1,`, N z k 11 <br /> INTERLAKE MATERIAL LING INC <br /> 1029 3- S11CR:ihIMENTO STREET 8$tatdGsnetaror°�tD <br /> LODI, CA 95240 <br /> 4.Generator's Phone 20 333-3500r <br /> a .. . , . <br /> 6.Transporter 1 Company Name 6. US EPA ID Number C,State Transpor*1V JD= "Q: <br /> ENVIR0k4MEM%L RECOVERY SERV_ C0 0 0 0 9 9 0 3 9 2 P.-fPansp©rter's Phone <br /> ..(662)`` 4T"T27? <br /> 7.Transporter 2 Company Name 8. US EPA ID Number �E.State I 7ransparter's ID "` <br /> MAUME£ EXPRESS }#- -77 <br /> N J D 9 8 6 6 0 7 3 6 0 E�Transporter'sPhone (8$$) 128-63D8 <br /> 9.Designated Facility Name and Site Address 10. US EPA ID Number G.State Facility's ID' <br /> RINECO R D 9 :8 1,0, 5'7 e8 �' <br /> 1007 VULCAN ROAD - HASICELL H.Facility's.Phone <br /> BENTON, AR 72015 <br /> 9 8 0 5 7 8 7 01 <br /> (5, Xy 77,840' <br /> 12.Containers 13. 14. <br /> 11.US DOT Description(Including Proper Shipping Name,Hazard Class and ID Number) Quota Unit t <br /> No. Type <br /> Quantity WtNol tgNo mss. <br /> E a. WASTE FLAMMABLE LIQUIDS, N.O.S., 2, UN1992, FG IT <br /> N (ACETONE), (DO01, F003) � <br /> E 11 114 G <br /> A b . WASTE METHYL ACETATE, 3, UN1231, PG II (D001) <br /> T <br /> O t <br /> R G <br /> c <br /> d. <br /> J.Additional Description for Materials Listed Above alT K EnmergencyResponsa li,#ormatipn <br /> - 05Q49, <br /> ROW 1.25, F003, �► METHXL SATE, 0106-0l�050, RG,E <br /> E £E Y lit C <br /> 5 <br /> 77 <br /> S <br /> if�nQ a6rTic a TSC) , rett r�1 ter gal>eratOr <br /> w <br /> 15.Special Handling Instructions and Additional Information <br /> EMERGENCY CALL ENVIRQSERV 1-562-427-72?7 is BILL TO ENVIRONMENTAL RECOVERY SERVICES tt <br /> USE PROPER SAFETY E NT**'HERS W.O.#16435rttHI*:r <br /> 16. <br /> GENERATOR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> packaged,marked,and labeled/placarded,and are in all respects in proper condition for transport by highway according to applicable international and national government <br /> regulations and Arkansas state regulations. <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 I have determined to be economically <br /> practicable and that I have selected the practicable method of treatment,storage—or disposal currently available to me which minimizes the present and future threat to human <br /> health and the environment;OR,if I am a small quantity generator,I hav, e a go ith effort to minimize my waste generation and select the best waste management <br /> method that is available to me and that I can afford. <br /> yped Name s Signature Month Day Year <br /> I , L I - I <br /> T 17.Transporter 1 A nowledgement of Receipt of Materials <br /> R <br /> A Printed/Typed Name Signature ? Month Day Year <br /> 1ZaZL4 ;;Z4 <br /> O 18.Transporter 2 Acknowledgement of Receipt of Materials <br /> R Printe p Name Signat Month D Ye r <br /> R ff 0 / A/u�Usa/� D <br /> 19.Discrepancy Indication Space <br /> L <br /> I <br /> T 20.Facility Owner or Operator:Certification of receipt of hazardous materials covered by this manifest xcept as n in Item 19. <br /> Y P ted/Typed Name Signatu � z Month Day yy--Y��ear <br /> �` ��4 <br /> - tJ <br /> EPA Form 8700-22(Rev.9-88)Previous edition is obsolete. <br /> NOTICE:THE ORIGINAL AND NOT LESS THAN TWO(2)COPIES MUST MOVE WITH THE HAZARDOUS WASTE SHIPMENT.ONCE DELIVERED,THE TREATMENT/ <br /> CTnDA#'-=1n1*Dnen/ CA9`11 ITV AAIICT DCTIIDMTMIC f%019-/111AI f%nDVTn TMC f1_CIAICDATf1D <br />