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Jan -14-_0_3_12:22P Wendt Construction 209 547 9310 <br />Form Approved OMS No. 2050-0039 (EApirss 9-30.99) S@e Instructions on bOCk OE 0 6. <br />Please print or type. form designed for use an elite 112-pikh) y <br />a 16 <br />0 <br />h <br />h <br />8 <br />!m <br />IQ <br />�U <br />Q <br />0 <br />g <br />Z <br />3 <br />cv <br />o <br />Go <br />co <br />v <br />N <br />v <br />0 <br />m <br />of <br />Uj <br />z <br />U <br />L" <br />LnZ <br />O <br />a <br />Ln <br />L" <br />cz <br />Q <br />Z <br />0 <br />a <br />Z <br />Uj <br />U <br />CL <br />J <br />N <br />sx <br />0 <br />Y <br />U <br />Z <br />LU <br />n: <br />W <br />W <br />0 <br />w <br />vo <br />Q <br />v <br />N <br />P_03 <br />Department of Toric Substances Control <br />Sacramento, California <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (1/99) <br />EPA 8700-22 Yellow. GENERATOR RETAINS <br />Generator's US EPA ID No. -. Monifoel Document No. 2. Page 1 information in the shaded areas <br />UNIFORM HAZARDOUS �1. <br />is not required by Federal law. <br />WASTE MANIFEST 511 12112�21 <br />f of f <br />3. Generotor s No an Mai Ing Address <br />rr <br />A. Generator's Phone ) 3i <br />a .•,. ;•'s �;+..r. <br />... <br />- <br />5. Transporter 1 Company Name 6. US EPA ID Number <br />.�5:' $bte'%y„t r - <br />/ ` r <br />.') � � to �•�w <br />, <br />7. Tron.po# 2 Company Name 8. US EPA ID Number <br />i, •, - f -:-„{ ,f <br />9, DesignatrI Facility Ngme ono to Addws 10. US EPA 1D Number <br />r <br />�'1$S!1! IAC j ♦ , `: I <br />��� �s drb�s sC <br />�F r�lly'ti-p • a - <br />(' ? <br />1 I . US DOT Description (including Proper Shipping Name, Hazard Claes, and ID Number) <br />12. Coiners <br />nta-13. <br />Total <br />QuantityWI/Vol <br />Unit <br />.: `• ” - • - - -' <br />a.", Wasb. Numb•r :':'. � �• <br />No. <br />T <br />x eiv /il s a[/ar ur . /s%v� <br />.Slob•. • �. <br />E <br />b <br />E <br />A.- <br />T <br />C. <br />:81ot� -. <br />° <br />EP,V <br />R <br />d.� <br />S7 <br />-07- <br />J. <br />1. Additional Descriptions for Mobrfols LiAted Above <br />c ,Handling Codes for Wastes Listed Above <br />x <br />1 <br />rt <br />6 171 <br />15. Special Hon •ng Instr tion. q� A ilio 1 In motion , <br />�rp�/' � <br />�Y � �'d`J <br />j/.sem <br />vf <br />16. GENERATOR'S CERTIFICATIO I .rely dedara that the eontenb of this consi®omen) ore fully and accurately described above by proper shipping nom, and ors classified, pocked, <br />labeled, for <br />marked, and and are in all respects in proper condition transport by highway according to applicable international and notional government regulations. <br />If 1 am a large quanliy generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to Ike degree I have determined to be economica11 <br />and that I love the treatment, disposal me future <br />practicable selected practicable method of slera®e, or currently available to which minimizes the present and threat to human heoll <br />and Ike environment; OR, if I am o small quantity generator, I have mode a good faith effort to minimize my waste generation and select the best waste management method that is <br />ovailabls to me and that 1 can afford. <br />Printed/Typed Nome Signature !' <br />Month Day Year <br />� r• <br />17. Transporter I Acknowledgement of Receipt of Materials <br />/ _ 1 r1 <br />T <br />t <br />In " Typed Nom, - <br />Signolur <br />- <br />Montt Day Year <br />I. <br />c <br />1` <br />9 d <br />t <br />18. Trontportor 2 Acknowledgement of Receipt of Materials <br />It <br />T <br />Printed/T ed Name <br />yp <br />Signature <br />Month Day Year <br />E <br />t <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />1 <br />L <br />120 <br />Owner or Operator Certification of receipt of hazardous materials cvered b this manifest .ace <br />Facilityo <br />t os noted in Item 19. <br />T <br />Prinfad/Typed Nome Signature <br />Month Day Year <br />Y <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 8022A (1/99) <br />EPA 8700-22 Yellow. GENERATOR RETAINS <br />