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SEP -24-2003 03:30 PM P.02 <br />_ �a�gprpEllVlfOlftw1rll<t111�1 - <br />Instructions on back of&176 D.parw Sarna Toxics California nice Control <br />Of1A6ft10. iceo.oap r <br />.prirrt or ryp.: iersn abs for�(j1 Pilch/ yprruilar• Sacramento, California <br />1. eeerotors LIS EPA 0 No. st Document No. 2. Page 1 Itdormation in theshaded areas <br />t V�MM RMS `- is not required by Federal low. <br />! WASTE MANIFEST CAD ®6 8 8 4 525419 4 6 4 9 ,t 1 <br />3.NI�o9 Addressessisme <br />lsT!! <br />- <br />et <br />i21g9;��4Ri 2'1'•' <br />Trwt pww 1 Nave : ♦5 EIY1 ID L z fi t f ; <br />Vill <br />4 <br />AMor <br />7. Transporter 2 Company me .,. .. fie ®Ntmlber �'. LL .; 3� � 1 '{ <br />j <br />2 E <br />V A.Dotgn Iedg _ _Facil Namgaadd Site Address 10. US EPA IDNumbr k <br />0Z 2111N NeWl aft Dr. NASt s <br />02 FipC!llttr<y, a W 89488 IV JV P 19 18 tO 18 1915 313 18 <br />=3 12 CaMoiners 13. Total 14. Unit <br />U11. US DOT Description (including Proper Shipping Name, Hazard Close, and ID Ntmtber)NO. Type Quantity Wt/vol `) <br />y <br />/low •"`'- � a'RUNDU tTli>I15t, 31BtID, I.O.S. jMi#j 9 AM♦77 Iii 16i1411 x ', <br />ItH A P <br />3 G;IYty <br />ni b. ' ... <br />a0 E04 <br />v. <br />A <br />T +� <br />r" -- <br />alit <br />LU <br />�@3 <br />�'r ,s xa �� *f sr i. is .sr` may. �v�.. ,•p t . 'k <br />507 <br />0 15. Spatialndi <br />ol Hang liatrudions and Additimwl Informationa!' r CUL 13n) "64W <br />Z IMI PIRMV1 a+M. flIfINII > IM! 101-1191 (775} 575-1777. <br />LU <br />,w <br />X <br />16. OffMATOWS � 1 deekae Ihd Aso contents of ibis cmnsignmeM are fnilp'ad gastro descrils d above by Proper afsipping name and are classified, packed, <br />marked, and labeled, and ae in alg c4 in proper condition for transport by highway awarding to a� scabfe iniarnahonal and rwtional governmaM regufaliona. <br />4 , tam a large quonfily generdfcr, I certify that 1 ham o p ram in place to re les& Mie volume an is of waste genmrated to the degree I have determined 16 be ec :Ro Zll <br />N licable and that I here selected the practicable method of treatment, storage, er disposal currently araifaMo to me which minimizes the present and future threat to human heahh <br />did the o"retimenty 9R, if I am a small quantity ganerotor, 1 haus made a good faitfs effort to minimize my waste generation and soled Mks, best waste management method that is <br />at 0 available turns omf "1 can afford. <br />y ed me Day Y <br />Viet— <br />•W <br />R VI. Trurraporter 1 Admawl of of Molsrials <br />Month Day Year <br />Pr" <br />� <br />W P <br />u. 'f 18:7 2 Acknow of Recce' t of Materials <br />Pri"led/Typed Noma Signature Month Day Yam <br />p <br />19. Discrepancy Indleral— Spats . <br />A <br />C <br />) <br />L t of hamrdaes marorials is manibsr exceptas noted ' 119 19. <br />I 20. Facility Owner or <br />T nn yped Name nature Morrlls Day Year <br />Y2Z Q ko IR <br />DO NOT WRITE BELOW Tws UNI. <br />Yellow: TSDF SENDS THIS COP' TO GENERATOR WITHIN 30 DAYS. <br />DISC t)t122/s 1/991 (5onerators wf- subm:- homrcous waste for transport out-ol-stare, <br />produce completed copy of tfiit copy and send 10 D15C within 30 days.) <br />ERA 8700--22 <br />