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State of Colifornic—Environmental Protection Agency 7-185-01 <br />Farm Approved OMB No. 2050-0039 (Expires 9-30.99) See Instructions on ba age 6. Deportment of Toxic Substances <br />Please priril or type. Form designed for use on elite (12 -AW writer. Sacramento, California <br />O <br />tO <br />W) <br />fV <br />a0 <br />O <br />O <br />00 <br />N <br />C <br />cc <br />ao <br />c <br />c <br />x <br />ae <br />LL <br />t— <br />Z <br />LL <br />4 <br />LL <br />V. <br />Z <br />C <br />a <br />V <br />LL <br />Gr <br />4 <br />2 <br />C <br />a <br />2 <br />LL <br />H <br />4 <br />L <br />CL <br />V <br />a <br />C <br />L <br />2 <br />LL <br />Q <br />LL <br />LL <br />C <br />LL <br />V <br />4 <br />L <br />1 <br />DO NOT WRITE BELOW THIS LINE. <br />1. Generator's US EPA ID No. Manifest Document No. <br />2. Page 1 <br />Information in the shaded areas <br />UNIFORM HAZARDOUS <br />C ALCDr, 0256206 06711 <br />1 <br />is not required by Federal law. <br />WASTE MANIFEST <br />of <br />3.enerator's Name and Mailing Address I' 1" rdr1 C:.$[ <br />'ITE: <br />A. Stale Manifest Document Number <br />228841 <br />4704 CT <br />Y+T1-yC KTO "U' A &2.5200:B, <br />t;d ..f a <br />State Generator's ID° <br />4. Generator's Phone ( 20 7) 946-3748 <br />5. 1 Name EPAID Number <br />C. State Transporter's ID (Reserved.} <br />. <br />eTrryanss^^poyrter <br />iCtomp�any <br />INC6. �sUS <br />�^ <br />�"A-FE 1 �ir"'"71L1C EN SYSTEMS, IN ! ' PI'001JSF5.�."rii9.{330 <br />D; Transporter's Phone <br />BOO 669--5740 <br />7. Transporter 2 Company Name S. US EPA ID Number <br />E. State Transporter's ID [Reserved.] <br />F. Transporter's Phone <br />Dai at dFa 10. US EPA ID Number <br />�}dal"' ex � '> ` t� INC <br />G. Stale Eocility'#,19. <br />�, 't t VV C ': 3 b8 <br />1 . r <br />4 AL I DA BLVD <br />�u i i i <br />H: Facility's Phone <br />�r°±o-050 <br />CA 95368 C;:dtT0006I ;396.8 <br />�;7ALID <br />209 545-101 <br />11. US DOT Description (including Proper Shipping Nome, Hazard Class, and ID Number) <br />12. Containers <br />13. Total <br />Quantity <br />14. Unit <br />Wt/vol <br />I. Waste Number. <br />No. <br />Type <br />a. USED CLEANING COMPOUNDS., N. €.f. I. B. N(. <br />DM <br />, <br />,.State 1'234 <br />LIQUID (NOT USDOT OR UOEPA REGUL..A7ED) <br />EPA/Other <br />G <br />AGUE OULS PARTS WASHER SOL -67110N (8. ;,3#GAL ) <br />E <br />b <br />State <br />N <br />E <br />EPA/Other <br />R <br />A <br />c <br />State <br />T <br />0 <br />EPA/Other <br />R <br />d. <br />Stole <br />EPA/Other <br />J. Additional Descriptions for Materials Listed Above <br />K. Handling Codes for Wastes <br />Listed Above. <br />a. 14 <br />b: <br />r. r, r.-1 ro's.6 n. r l <br />c. <br />.. e <br />d <br />t5ei« <br />3647545J ! .7. S G G <br />yaac� ,j `yam �qn q p}�,qn p '4/3 T V4 t <br />ercgal� S �+nstfi' iM"I 1w+dLJtV °I�ef.°`lrflJ t'°3. l iS0 24 R <br />gert5 O <br />A 941 B C 0 <br />16, GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper ship�ing name and are classified, packed, <br />in for transport by highway according to applicable international and notions government regulations. <br />marked, and labeled, and are in all respects proper condition <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 economics <br />and that 1 have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human heal <br />practicable <br />and the environment; OR, if I am a small quantity generator, I have made a good faith effort to minimimy waste generation and select the best waste management method that <br />available to me and that I can afford. 14 I <br />Princeyped Nome <br />Signature <br />Mon2 <br />/7` <br />i <br />17 ; rons orter 1 An wled ement of Receipt of Materials <br />RMont <br />A <br />Ped/Typed Na ign D <br />r t <br />S <br />P <br />0 <br />18. Transporter 2 Acknowled ement of Recei t of Materials <br />RPrinted/Typed <br />Name <br />Signature <br />71111 <br />Month Day <br />E <br />R <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />L <br />1 <br />20. Foci Owner or Operator Certification of receipt of hazardous materials covered by is nifest exce t as voted in Item 1 <br />TPrinted/ <br />Name t <br />Signature <br />a, C. <br />Y <br />'ta- 6 k- G/ <br />CWJ <br />DO NOT WRITE BELOW THIS LINE. <br />