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State of California—Environmental Protection Agency 7-185-01 <br /> Form Approved OMB No.2050-0039(Expires 9-30-99) See Instructions on back of oae 6. Department of Toxic Substances Control <br /> Please print or type. Form designed for use on elite(12-pitch/ riter. Sacramento,California <br /> UNIFORM HAZARDOUS nerator's US EPA ID No. Manifest Document 2. Page 1 Information in the shaded areas <br /> C!$6D074642901 29 790 1 is not required by Federal law. <br /> WASTE MANIFEST of <br /> 3. Generator's Name and Mailing Address *A AL M14MUL 1 TY4 A. State Manifest Document Number <br /> 1029 S SACRAMENTO <br /> 0 L ODI CA 95240--4799 B. State Generator's ID <br /> 4. Generator's Phone ( 209 333-3500 <br /> f\, <br /> N 5. Transporter 1 Company Name 6. US EPA ID Number C. State Transporter's ID[Reserved.) <br /> LO <br /> SoO <br /> 5740 <br /> o SAFE;T Y—AL.EEN SYSTEK t INCSCIR0 751 D. Transporter's Phone `� <br /> aD 7. Transporter 2 Company Name 8. US EPA ID Number E. State Transporter's ID f:eserved.j <br /> b QF. Transporter's Phone <br /> U 9.,De''gtdpt$d Eacility d ri[ A 10. US EPA ID Number G. State F ity <br /> Q7ftrafi r IInSagk <br /> .� 1)osk +z <br /> t r 's 3 tr ^ e e" "7' H. Facility's Phone <br /> ,F: ' 'I�B� ,_,epi, �P,.r �#:5 .K�;�;��� '^�,��, h <br /> + " <br /> J 12. Containers 13. Total 14. Unit <br /> Q 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) <br /> e Quantity Wt/vol I. Waste Number <br /> F a. ED CLE4kN1KG COMPOUNDS, N�A gy p �r yq G State <br /> N. 43+ A . S. #'+ . #d DTC <br /> 3 G i._i. I D (NOT T OR EFS REGULATED) <br /> GULATED) EPA/Other <br /> AQUEOUS PARTS WASHER SOLUTION (8. 3#GAL.) , <br /> E b. State <br /> °D <br /> co E <br /> R EPA/Other <br /> C. State <br /> EPA/Other <br /> State <br /> EPA/Other <br /> ;Additional Descriptions for Materials Listed Above K. Handling Codes for Wastes Listed Above <br /> a. b. <br /> 14 <br /> C. d. <br /> "1790 00024t5397 09 <br /> 1 k tr o of I or ion l <br /> 1760 24HR <br /> SIK AUTHORIZED O RETAIN LICE14SED LICESUBSEQUENT CARRIER, AS N CES A Y'r <br /> A 941 EI C D <br /> i 16. 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,packed, <br /> U marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> if I am a large quantity generator,I certify that 1 have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> CL practicable and that Rave selected the practicable method of treatment,storage,or dispgsal currently available to me which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a small quantity generator,I have made a good Fait effort to minimize my waste-generation and select the best waste management method that is <br /> c1' available to me and that I can afford. <br /> > . Pri d//BTypfed Name 9 Signature ri Monthv Day Year <br /> Z <br /> w RT 17. Transporter 1 Acknowledgement pf Re i t of Materials <br /> LU A Prin d/Typed Nome /� Signature P fir' Month Day Year <br /> LU P d ,.� b" 1 <br /> U_ g 18. Transporter 2 Acknowled e2 nt of Receipt of Materials <br /> T Printed/Typed Name Signature Month Day Year <br /> LU E { <br /> N R <br /> Q <br /> U 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> ) <br /> I 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> j Printed/Typed Name Signature Month Day Year <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A (1/99) Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br />