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fSta a of California-^Environmental Protection Agency { <br /> !I Form Approved OMB No.2050-0039[Expires 9-30-991 See Instructions on back Q e 6. Department of Tasie Substances Control <br /> Please print or ype. Farm designed for use on elite I)2-pircfrl�ifer. <br /> Sacramento,California <br /> UNIFORM HAZARDOUS 1' Ganeto is US EPA 1D No. Manifest Document No. 2. Page I Information in the shaded areas <br /> + is not required by Federal law, <br /> WASTE MANIFEST C, [` Z/ eA p' at 1 <br /> 3' Generator's Name and Mailing Address r A Masnfea Daurment Number <br /> 57'�G7�N T����L �Cr95Tt�erh! r�•g�c_2�4.� �,. �; �-�•"-,� `� 3�'�c7�'�t��l''!'�.�.`,��,,r�`� <br /> tg''JJ�/`0�' I�" 7L�.GT4� c�• 9S2D'� ������,at �� � Y z'� � ' - ' ! <br /> LO <br /> A. Generator's Phone I ) 7{alp ��a/ frD � iV <br /> . tet F <br /> (V 5. Traft er. I C7ny Name <br /> p <br /> rJI�DUS�i�tE �"Y sp01'IQfs.�`l.1t 4 <br /> 4 61 <br /> uJ T t <br /> m <br /> r6 � YS t,MU+'•,1..S. <br /> . s I <br /> VD�Tr'akr 5 ss Phonr� i f F'4»�sZ '7�' ! <br /> C? 7, Transporter 2 Company Nome B. US EPA ID Number <br /> `:'.�'�!'x..>,.�. :r kz,ac3-., s'". 1.++<•f�..-..a't.'?x.Z1'+b' u'1"d,r <br /> Q <br /> 9, Designated Facility Name and Sife Address 10. US EPA 10 Number Cr .,!�F <br /> ERICKSON INC. + W- 10-1 <br /> x <br /> Q ' <br /> e-q� 255 PARR BLVD ani �r <br /> Cn <br /> URICHMOND, CA 94801 c- <br /> 0 �. :sl " .�-23fit1393 <br /> • --s 12. Containers 13. Total 14 Unit * 1'F;x <br /> U 11. US DOT Description I weWieg�trapii Shipping Name,Hazard Class,and ID Numberl No T a Quantity WI/"al 1.�.WasfaNumbam <br /> z <br /> WASTE EMPTY STORAGE TANK T M <br /> . l <br />' a 13 c Non-RCRA hazardous waste Solid il TWIG igS7 F "'MRs ;a .- <br /> G O N <br /> 00 E <br /> v A <br /> d T '? <br /> O ; <br /> Uj ;d. <br /> r <br /> -� W - <br /> 'IC�"HandliegCodesj6i Wast <br /> - <br /> _- <br /> i - i t - o rvs �•wa5 . L t �t'� sa ,F �� s+ w 'b 7tv y rir" h <br /> Z '", c (L f F2 <br /> - O Y`k.'• '� .b��Yi��41T6�iiy��� ��y�� 'f ��1' .t G 1 t: '�'AX�iY''�iL)��.��T•. �ll.�`.M's�� Z L <br /> STORAGE <br /> S i-iAUE BEEN INERTEi] <br /> ANK( ): <br /> Z 15. Special Handling Instructions and Additional Information <br /> ear appropriate protective clothing when handling. SITE LOCATION: <br /> jz 24 Hour Emergency Telephone Number ERG# 179 <br /> i24 Hour Emergency Contact: ' <br /> r <br /> 16. GENERATOR'S CERTIFICATION: !hereby declare that the contents of this consignment are Fully and accurately described above by per <br /> shipping name and are classified,pocked, <br /> Q marked,and labeled,and are in all respects.in proper condition for tronsport by highway according to applicable international and national government regulations. i! <br /> r <br /> U <br />' I if 1 am a largo quanfiy generator,I certify that I have a.program in place to reduk a the volume and tasiciky of wase generated to the degree I have determined to be acanamica y <br /> N practicable and that I hhave selected the procticiibie method of treatment,storage,or disposal currently available to me which minimizes the Present and Future threat ra human health <br /> and the environment;OR,if i am a small quantiy generator,I have made a good faith attar]to minimize my waste generation and sdeU the bee!waste management method that is <br /> available to.me and that I can afford. <br /> I O month — <br /> Printed/F ped Nama Signature � � <br /> Z <br /> su T ]7. Frans rter 1 Acknawled amens of Receior of Materials <br /> R Print T oma Signatpr1a r *-ph Day Year. <br /> LU <br /> La I= z3 <br /> Year <br /> s� p 18. Transporter 2 Acknowfed ement of Recei t of Materials Month .Day <br /> P . <br /> O 9 Printed/Typed NameUJ <br /> E Signature <br /> R <br /> _m4. V 19. Discrepancy Indication Space f <br /> A F <br /> 71 <br /> C a <br /> l 20. Fat li Owner or Operator CeAi6cation of recei t of hazardous materials covered this manifest except as not <br /> in[rem 19. month Day Year <br /> T Printed/Typed Name Signature P <br /> a .T Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> i <br /> Blue: GENERATOR SENDS'1'H1$ COPY TO DTSC WITHIN 30 DAYS- I <br /> DTSC 8022A;4/971 To: P.O. Boa 400, Sacrnmenro, CA 95812-0400 ; <br /> EPA 8700-22 <br /> . t <br />