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of Caklornio—fmvwennrd Protection Agency I <br /> ,roved OMB No.2050-00]9 E s 9-3P9� 0 SM Instructions on back of • 6. <br /> type, Fane designed foron elwe 12 �9\ 4k Department of To"Su California Contrd <br /> ,t or siso <br /> I t�l7P�'r+�tr• Socrareereo,California <br /> 1. GettwrON'S US EPA 10 No. Manifest Document No. 2. Pape I Info.maron n tie shaded areas <br /> UNIFORM HAZARDOUS <br /> I I is not required by Federal low. <br /> I WASTE MANIFEST ICIAIL10101011111116181810 10 10 0 1 3 1 of 1 <br /> 3. Generator's Nome and Mailing Address Zuckerman-Mandeville, Inc. A. Stale Nimiest Documens Number <br /> I P.O. Box 487 92466399 <br /> Stockton, CA 95201 fl. State Generator's ID <br /> .. Genetwor'sPhone ( ) (209) 464-8355 <br /> 5. Transporter 1 Company No a US EPA 11)Mmber C. Slate Tra-porters ID 400764 <br /> I Falcon Energy Associates ICIAID191812151216181517 D. TronapOf1er'Ph— (209) 463-7108 <br /> 7. Transporter 2 Company Nome 8. US EPA ID Number E. State Tronsporwrs ID <br /> I F. Traroporser's Phan <br /> §tat jValMilLnV inn SdeA d ,44s 10. US EPA ID Number I ' G. Saw Foalny's 10 <br /> 12618 Main Street <br /> I H <br /> Los Angeles, CA 90068 CAD 0 0 0 0 8 8 2 5 2 Fa�dryt f (213) 756-7896 <br /> 11. US OOT Description(including Proper Shipping Nome,Hoard Claims,and 10 Number) 12. Containers 13. Total 1A. Unit <br /> No. Type Ouant Wt/Vol I. Waste Number <br /> a• RQ, Waste Paint, 3, UN1263, PG II Stan 214 <br /> G 010 1 D 0 0 p G Fept <br /> gb. Non I UA �aatardo�s v acesic Co(i� 5iariU�UlZ 3 <br /> R b /r D f EPA/Otlnr <br /> A �1 <br /> c. State <br /> n EPA/Other <br /> k <br /> d. Stotts <br /> EPA/OIMr <br /> IJ, alt scr prions ice Mo•rids Lewd Abe" ;,,. n ';• K. Halling s lot Wows listed Above <br /> 1��a�ar�.ous pant canr,� •� ,_t:.:;;...;,',;:c':X�, '�. _ a. b. �� <br /> C. <br /> r�� tiss1► +'s �+..,fit;t}', T y <br /> 15. Speuol Hadlrrg Instructions and Addifonol Infarrwaiat 24 Hour emergency response number 1 800 399-4357 <br /> I Ila. P- 15576 <br /> G.in I&ens "P 1) Tyvcl S✓li►s� pr)y woao/ 0;1Y &Vfr~l., v sly f s.cJS� orrJ24-7 C0fI-hr.A/`.j <br /> K'c <br /> 16. GENERATOR'S TIFICAT N: I hereby dechore that Ilse cordra of the consignment are fully and occuraely described above by proper shipping name and are classified, <br /> packed,moped•and labeled,and we in all respects in proper cors"' - for trasport by highway o"otdup to applicable federal,state and international laws. <br /> IIf I am a large quantify generator, 1 certify that I have a program in plate to reduce Me volume and toxicity of waste generated to the degree 1 have determined to be <br /> ecanbmKalhy prattKable and that I have Selected Mn procloceble woodsod of A ealwent,storage,or disposal currently ovailoble to me which mnunues the present and future <br /> threat to human health and the eavacirdnenl;OR,if 1 am a swag gwnfY gwrr'abr, I have made o good faith effort to mn,mue m aste ganeratwn and select the best <br /> waste management method that is available to rise and Mat I can afford.(hl behalf f Zuckerman-Mandeville Inc. <br /> Prated/Typed NamertrAMtl Month Day Year <br /> 0 4 D L 14 y <br /> 17 Transporter 1 Acknowledgement of Receipt of M deriab <br /> Printed/Typed Nome Sigrtsttw / Aenh Day Year <br /> 18. Transporter 2 Ackrawled ement of Receipt of Materials <br /> Printed/Typed Name Sigrtabn Month Day Yew <br /> ■ <br /> 19. Discrepancy Indication Space <br /> I <br /> L <br /> 20 facility Owner or Operator Cemhcation of rete, t of haaordous moteriafs co b this manifest except as oted in Ise 19. <br /> Pnn /Typed Nan• <br /> LaU Month Oo Yeor <br /> � m" Ll_�_ l <br /> DO NOT WRITE BELOW THIS UNE. <br /> Whit.: f'.uf Srra. lril:, COey 1(� 01%C WtJrtu+ :30 DAYS. <br /> ts022A (7/92) To I'.U. tea,, .,,n10. S...rwnauw. CA r/.bl'L <br /> 8700-22 <br />