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CK $ <br />Mailing Address <br />"`b►e <br />.S <br />ONO No. 2050-0039 Expiros 9-30 9) <br />i S <br />LP <br />I %� �'Agec <br />6.Department of Taxic Su6dances Control <br />of page l <br />Plouso print or type.`form clasigned for use on elite (12pikhi typewriter.Sacramento,California <br />1 <br />o <br />-0mmEwy Ccs . : c800i 7, 46-7441" <br />'UNIFORM S <br />1. s US EPA 11) No. hlanifesf <br />IC�11L-101010101416tglalsll <br />f No. <br />2. Page 1 <br />Information in the shaded areas <br />is trot required by Fedora) law. <br />& <br />5. Transporter 1 Company Nam 6. US EPA 8) Number <br />WASTE MANIFEST <br />e <br />0� f� <br />of 2 <br />, <br />13. Total 14. Unit <br />Qoartily I Wt/Vol <br />P <br />Mailing Address <br />® <br />456? ENTERPRISE NT - <br />1 <br />o <br />-0mmEwy Ccs . : c800i 7, 46-7441" <br />r °P', CA 94538 <br />NA. <br />Generator's Phare (209 1 461-76321 <br />5. Transporter 1 Company Nam 6. US EPA 8) Number <br />rN <br />CD <br />SHOD HhZARDS 3OLTYPTONS C A 0 0 0 0 6. 4 6 4 917 <br />, <br />..� _C?7 <br />, proper <br />--J—+-+ <br />H <br />� Tru p - <br />Com 8. US EPA ID Number <br />`♦. <br />B i cm o kugo quantiy gxssrabr,l'asrtify that 1 have a in plcoe b reduce the volume and waste b die degree 1 have determgned b be economically <br />p`ac"cable and that 1 hanro 11ro tr hnent, a rGspascl airr�dyb6 b me which minimizes the and hAufe threat to human health <br />i � <br />( <br />1 c x IV f tg1. 7 \�- v J .� • C l <br />-rya <br />,d <br />Oavailalde <br />Fir Dasiglnabd Facility Name and Site Address 10. US EPA 8) Number <br />21 �t Ctt3n t 7;-A Z <br />to me and tlrot 1 can afford. <br />Z� <br />2095 =V S TDR_ E <br />Prim /Typrpd _ f Q s ` <br />lq.� Std x- 1t <br />/ / � <br />7s <br />A�th Day Your <br />�� <br />F EY, APV' $990$i4f N IVID 9 $ 0$ 9 Is a 12 ja <br />s <br />.r <br />,,.. <br />11. US DOT Description-jincluding-Proper Shipping Nam, Hazard CTW; and 8) Number) <br />12. Conbim <br />No. <br />T <br />-' <br />a-WASTEI-FLAMMBLE SOLIDS, ORGANIC, AP .O. S . , <br />R <br />Printed blame r <br />/��K <br />tz- <br />' <br />4-1, iftt1225, II ( OLIMSENZENE) (11001, D01$) <br />W <br />P <br />e/!�d► <br />G <br />- <br />0 0 1 <br />D <br />0 <br />E <br />N <br />b <br />T/Typed <br />Co <br />ao <br />t£ <br />Y <br />N <br />R <br />Dai{ <br />4 <br />R� <br />w <br />O <br />:= <br />k <br />1.9. Discrepancy Indicalion Space <br />z <br />A <br />d. <br />U <br />1 <br />13. Total 14. Unit <br />Qoartily I Wt/Vol <br />P <br />4 i'?i�°�,`�,-i�Gt�, �'.'''�i's k � Ckr, �d.":���€5`- �::2"�^•U.+fit�.' k ` <br />® <br />APVMwtft 10 v JOS SITE: 7272` WEST LN., STOMM, CA 95210 <br />-0mmEwy Ccs . : c800i 7, 46-7441" <br />Z <br />W <br />SEE E_R-G. B * 12 <br />J <br />4y¢ <br />16. CsENERAT`5 TION: 1 hereby declare that the eorNoMs of this consignment aro fully and acmraWy described above bypnaporsh,'ng name �d me elassifed, packed, . <br />marked, and and are in all respects. in cndition, for transport r� b highway a�cordiicalsk ' and- - rogubrtwns. <br />, proper <br />--J—+-+ <br />H <br />B i cm o kugo quantiy gxssrabr,l'asrtify that 1 have a in plcoe b reduce the volume and waste b die degree 1 have determgned b be economically <br />p`ac"cable and that 1 hanro 11ro tr hnent, a rGspascl airr�dyb6 b me which minimizes the and hAufe threat to human health <br />and the orvironnreit; OR, if I amr a geantity , 1 have made a good faith effort b minimize my warm and select best waft t method that is <br />Oavailalde <br />to me and tlrot 1 can afford. <br />Prim /Typrpd _ f Q s ` <br />lq.� Std x- 1t <br />/ / � <br />7s <br />A�th Day Your <br />�� <br />Z <br />C., -1 tJri <br />o <br />9 <br />17. Transporter 1 '.4nowledasesent of of Materials <br />y0j <br />R <br />Printed blame r <br />/��K <br />Signature <br />Your <br />W <br />P <br />e/!�d► <br />1 V <br />It <br />W <br />a <br />8. Tronxv.,W 2 A cknowledgement of Receipt of Materials <br />T/Typed <br />Y <br />Name` <br />Dai{ <br />4 <br />R� <br />(J <br />1.9. Discrepancy Indicalion Space <br />Z <br />A <br />C <br />1 <br />_ <br />L <br />20. Facility Owner or Certification of sews this manifest as reefed in hmn 19. <br />T <br />PriPie ` ignatura . 1.. _ <br />MmA Day Yea <br />43 <br />' .,''DO : NOT WRFTE BELOW THIS LINE. <br />S Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. <br />lr... Mf——h. ..,h—;* h.—A—. ,.,,,et., Inr trnn-f nut -of- W. <br />