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'19'96 008:30RM RMC LONESTAR - . F.2 <br /> ;w•.. , <br /> star:e+z�alaemla--en�ir«� Sao.Instructions.on back of 6. D.Wodmwir of toxic suax,�,Co"I <br /> arm Appreredi::oh►B Nati.zosa-t} lfes 9�soaep` Sacromraey CaEfami■ <br /> hl�aewpehrfortrt+d- d�+l 'useeeietre(IZpMIA? + r�- <br /> 1. t3etrorafot's •!►A ID.No'. Mard oot Document!No. 2. Pogo i P d.d:dr eu <br /> r !J[r11lcORIVRI�Ilp17Jx8D,�US is++4trequiiedbrFedeie4levr. <br /> WASTE mA NiFi � �. 7; of <br /> 14/1 <br /> ' rain s Nome+arrd• allfit�fAtidwse•, r <br /> lot <br /> Noma 76; US EPA ID Number <br /> r. 'ypa G69fi78f' <br /> .Tren6p4rMr 2 Cam pargr•Name. L US'EPA ID Number <br /> 4 <br /> Fajbjr Site:Addresi ,I OR U8 EPfk,ID Number . <br /> �'� ,i�8�•Si�li�Rvenua <br /> 4 ew k� C; 8 .a 8• '8 T 4 11' 18 <br /> la. Can►alnere 13. Total 10.,Unrt0 <br /> _ 11.•US.DQr..DesisipNon(Includiisg Proper ShIPPing;t�at►ss,Mazard'Cldee,and it7 Number) No pug Wi 01 <br /> Wffh&A HAZARGOUSMASTE;1:GUID 0,111,11 <br /> b, <br /> IL <br /> tY' R <br /> W d,. <br /> V <br /> a2-' i <br /> ode• 'fit :",�' �'�° <br /> ���1..�` .�,�: a �;,�•. � y 1a err �s;e 3s <br /> ��'d' wf w •"«fti� fT�:.. �./v,?`J y, �,..:ee�'z•,u '�Yti!'3�3._ " ..a'•'``y',;a f <br /> , <br /> IS.�081Mdg6fllypgs o^s and AddWienel Infermamen <br /> 11�1jj f�;M�il(II�a7CC11YYGT <br /> CALF:CHEMTREC <br /> _ . 1.0*424.9300' <br /> DOT ER11131 NEAR PROTEMYE EQUIPMENT <br /> 16. GENERATOR'S MTIPICATION: I hereby declare that the eentems of this consignment ore fully and accurately described above N proper Shipping name ond•aro classified:'^ <br /> Vpacked,marked,and labeled,and ore in all respects In proper condition for transport by highway according to appllaoble international and national Government roqulotions: <br /> If I am a large quantity generator, I certify that I have a program in plate to reduce the volume and toxicity of waste generated to the do9rcx I have delertnhred•to be. j <br /> cconamicolty practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future- <br /> 9L <br /> threw to human hoalth and the environment)OR;R 1 am a smolt quantify generator,i hove mode a good faith effort to minimize my waste gonerailon and select the best <br /> e: waste nano ement method that It ovgilable to me and that I con afford. ' <br /> QPri pad Name IZ-319 IV 'IV 14 Jo <br /> Sig AAenNt D r <br /> 'yL <br /> ZTR T7. Transporter 1 Atknowled ensent of Recfi P f Materials <br /> (U AM. Printed ped Namej; Signature Month :?Day' Year f <br /> P: 78.-[mm r 2 Acknowled mens of Receipt ofbAgjdak <br /> 'Prfited/Typecl'trame Siq re. AWA Day..;'1•' Ystar <br /> 19, Disaroponcy ledieatfan Spans <br /> C <br /> L` 20. Faeil' Ownor or rotor fk of recei taF dous materials coverod b this manif' o t ac noted iR to <br /> Year <br /> T Printed/Typed Name SlgrSignaturefrbnth �1', <br /> 130 NOT WRITE BELOW THIS LINE. <br /> Blue GENERATOR SENDS THIS COPY TO DTSC WITHIN 30 DAYS., <br /> r=8034A (9190) Tor, .P.O. Sar A00,Sacramento, CA 959124400' <br /> EPA 8700—•22 <br />