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SENT BY: 2-28-85 : 1:23PM aRAMOS ENVIRONMENTAL- <br />�3ntte of Cdlfarnto--Eovlromner" li tecti4i'Agseiey ` Vit- 'hat o <br />Ferm Approved OMW'No. 2030-00.•!9• jALItes 9,"y r 5ai•• tr'uetions on back of page 6. <br />[Frio prior or type. ' Form dwipred fdr se on 0610 (1?pftcG} typewrfbr, e p g <br />UNIFORM HAZARDOUS <br />'' ro"Wrotor s US EPA IprNa' Manifest Oocvment No. <br />e <br />2. page 1 <br />WASTE MANIFEST <br />F 3 Z ` �5 1 -7 3 S <br />of � <br />3. Genemear'i Nome and Mailing Address •'s t <br />I'af:1t1.: ,all <br />2600 Cximfno R•' one ni►' , 2 RO <br />§Ln f� morin- a .r' IV fr� <br />d. neralw s Phone3, �I +OJ % <br />3: Transporter 1 Compony Name 6. US EPA Io Number <br />7. Transporter 21-omporry Name 8. u5 EPA ID Number <br />Dssiprsefad facility Norris and Site r 10. US EPA ID Number <br />Z. <br />11. US DOT Description (Including Proper Shipping Name, Mazord Class, and 10 Number) 12 CotsPanen <br />Ne. T <br />o. - _ t%1 tLi© Ill C 1✓ <br />f <br />N b• <br />E <br />R <br />A <br />T c. . <br />O <br />R <br />d, <br />510 372 5220: 2/ 2 <br />Department of Text Su6shmcts Cemrol <br />Sacramento, colifornio ' <br />Information in the shaded orimas <br />is not required by federal law. <br />13. Total I M. Unit <br />15. Special an ing Instructions and Additional, Information C <br />171►eSywi:E3o-,Zli:it? \�'r�C�:i.:. I�} L;=' 3'i %/ % IF %Z <br />for ias:c:?yrs en l:otir <br />7-,IA;4 <br />16. GENERATOR'S C6RTIFICATION1 <br />I hereby declare Mat the Contend of the consignment are fuPly and 4curaftly described abore by proper shipping name and are clomifirtd, <br />packed, marked, and labeled, and aro in all respects in proper condition for transport by highway according to applicable federal, stare and international laws. <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 1 have determined to be <br />economically preKticable and that I have alecfed the practicable method of treatment, storage, or disposal currently available to me which minimizes the pliant and future <br />threat to human health and the environments OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best <br />was$* ma merit method Char Is available to me and than I can offord. _'I <br />Pri V NM C Rn N A 0 Sig to L I,� / � I <br />N �.1� u r <br />t 17. Transporter 1 Ackno-64 mere of Receipt of Materioit <br />• Prirm`i� Nome r' Slggaturo <br />j ! rY0e4 <br />I...i0 112 Transporter 2 Aeknevrlad meat of Receig of Materials j/ <br />TPrinted/Typed Name Signature <br />e Month Oxy Year <br />19. Discrepancy Indication Space — - <br />Farmed!Typed Nate <br />///�/•y /� Signature <br />Months Day <br />DO MEDT WRITE BELOW THIS <br />DJ8022A (7/92) <br />