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Plem print or (Form for use on elite 12:j#ch .) Form .OMB No.2050.0039 <br /> UNIFORM HAZARMUS 1.Generator ID Number 2.Pager lot 3:Ertwtgaricy Rcapanaa PSmrm <br /> WASTE MANIFEST CAL000355717 1 800-893-8283 Q09555 1 <br /> 5,GaneratoraNameendPdaSngAaidro� ATN:Paul Bisch er Gatraaabrtstteaadreas(Hdirtaeanttl>mn addraEse} <br /> UnhersEil SeNce Rep <br /> ing,Inc Unlarsal SwMc s Re pling,Inc <br /> , <br /> 3200 S.EI 06rado t 3200 S.EI'Doradn StriM <br /> Stockton,CA95M Stockton,CA 95206 <br /> oerverawa Pham: 209-944-95M <br /> 6-TrareportericuromyMme U.S lD <br /> in onium ac ramento "ERI PHONE-Gust IN 8766-0004°"` 000179747 <br /> 7.T 2 <br /> S;EPA 10 Number <br /> r <br /> S. Norma Sita U.S.EPA ID Number <br /> US Ecol Bt3a##yhIVT390010000 <br /> Highway -12 ml.S or tty <br /> Beatty,rIv 0 -239-3943 <br /> End s fes: <br /> 9a. 9b•US.DOT DasalpYott(nck dog prof Shh*V Name,Hazard x,10 Number, 10.Containers 11.Total 12.Unft 13,Warta Codes <br /> HM and PeddN GMP(ff fY)) No. Tera Qua" W'Not. <br /> 1,Non-RCRAHomrdous Waste Solid(Absorbent,010 352 <br /> OA- <br /> 3. <br /> i <br /> 4. <br /> ?4. i instjsut�ns and _ _ <br /> Document D50895 Sales Order 68006 <br /> 1)Pmfl11e#070128300-24874 DOT ERG# <br /> 15, GENSRATIR 8 4FFEROR'S CERTIFICATION:A t rahy drat the twrtimlia d Utls rflcsatgttment era roily sed eowrn j da4a4rzd above by the pr r dn9 td ,dd ere <br /> mmkad and U ,and are(n all r h proper concift for transport ecmdaxj to htarnstlonal mid nabW govarrvrrontel raguiatia»N export aMprrant ant I am the Primary <br /> Exporter,I wally that the wr>m to of We comill m W conform to the tame of the attedwd EPAAdmaatedpment of Consent. <br /> I <br /> w*Mt Uv waste mMILdw datamont Idartf ned In40 CFR 2t12.27(s)IK I am a large quentlly )of(b)01 ern a email querdfly )Is tax,. <br /> EGA <br /> �p <br /> Goners PdnterNrypedUama <br /> 0 Import W U.S. ❑Er�rt flan U.S.' Pott of entryte* <br /> Tranvorter sigWors( exports MY}; Date Iaavkrg U.S,: <br /> i 17.TwWW 4*M6#nent of RwW et Materials <br /> rte ptxtat 1 PdrstRTyped Roms Day <br /> War <br /> t f0 <br /> ILI <br /> Traris{:ottar mos' <br /> moo Darr YM. <br /> 18,Otsorepetwy , <br /> 988.Grscsspancy In 9o-(J n Spacer ❑ 4uantity L J TO ❑Residua ❑Partlat Refed. Full Rajadon <br /> MoNfest Reform Number: <br /> Ieb,Ahmale Fedgy(orGanstator) U,S.EPA 10 Number" <br /> v <br /> tX— F&CWs Piwne: <br /> 160,Srnalure dA3temate Fatldly a kx} htonN sy ear <br /> 19.Hazardous Waste Report Management Matiwd Codas Q.e.,coda fcr hazardous waala treetmont,daposai,aril Wi6qVistiefti <br /> 1. 2 S 4 <br /> 21 Des mtsd Fadity{honer or Operates:Cetdkst an pt of haza*"mawriats covered by the mardest a Ind <br /> a� <br /> EPA Form 8700.22(Ray. Pravloiseditian® DE !'ED FAcit7fr`To DESTINATION STA (IP REQUIRE-D) <br />