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MAY-12-2005 13:51 FROM:TRACY TCK & AUTO S 12098325307 :4683433 P.8 <br /> State of California--Environmental Protection Agency <br /> Forel Apprevod OMB No.2050-0039(Expires 9.30.99E See Insfruefions on back of 46 6. Department of Toxic Substoncas Conlral <br /> Please print or type. Form designed for use on afire f f 2-pitch)rypowriror Sacramento,California <br /> UNIFORM HAZARDOUS <br /> 71Gqn,;,rctor's US EPA ID No. Manifest Document No. 2 Pogo 1 informuiiu.r the shaded areasrs not required by Federal law.WASTE MANIFEST r 10 10 10 ? er 1 10 10 11 9 s 9 <br /> 3, Cionerater's Name and Mailing Address A. State Manifest Document Nemlwr <br /> aAcrv��l 91892 <br /> o <br /> Te f� � B. slpt0 Ganaratar'e IU <br /> � <br /> Y, TItAGY CA � <br /> to A. Genereler's Phone 1 R91�1OJA�...iY)ll7 <br /> CV 5.Transporter 1 Company Nome b. US EPA ID Number C, State Transportet'S ID 1 �,f <br /> LO <br /> o° D. Tran rter's Phone (NO)9744" <br /> ASBURY P-MIRc�li�.� AL SERVICES �: A �� V 1 0.l i� r(.I l ��3 1 l� � <br /> 7 Transporter 2 Company Name 8. US EPA ID Number E. State Transporter':ID Reserve .1 <br /> netr�q @ F. Transporter',Phone <br /> . y 9 Designated Facility Name and Site Address 10, US EPA ID Number G. Slam Facility's ID <br /> wr9 .ie Ey3ry1 K�-^/ESI.V^pV.3tF�iyt��RIIl�Av9E�fgitrTgA-Lt <br /> d'J Z �D40BO AG�J�67�sT 20Tr�H 671 RL:EL 1 H. Facility's <br /> Phone <br /> 6� <br /> 2 LOS ANGELE'S (e �l 2� A t' f? fi 1? t) .� � ¢a S 1 )�pm"rjU:rV <br /> , 12, CC;ontainors 13, Tota) 14. Unit <br /> 11. US DOT Description(including Proper Shipping Name,Hotard Claes,and ID NvmborlNo. Type Qvanti W!/Vel 1. waste Number <br /> o. <br /> s NON-RCRA I DOUSWr�'ASTF-, SOLID(011Y ABSORBENT) state 152t= ®Oi ® P EPA/Oth., <br /> E 6. <br /> Stare <br /> 00 N <br /> ao -, 1 <br /> E EPA/Other <br /> v R <br /> N <br /> V A c State. <br /> o T <br /> m O EPA/Ulher <br /> R <br /> d State <br /> Z <br /> U EPA/011ier <br /> (n 1. Additional Descriptions For Maleriolsvs!o Above K, Handling Codes for wastes Listed Above <br /> , <br /> 11A)MV1y ,, . 3 bi <br /> w <br /> wce d. <br /> 0 15, Spajiol Handling Instructions and Additional Information <br /> 11SEPPF EWRC*-,NCY CAWACT'CHEMTREG M042 <br /> NAERG# 1% 171 <br /> z <br /> SITE 3W N.TRACY BLVD., MACY.CA W70 <br /> a 16 GEMERATQR'S CERTIFICATION: I hereby declare Ihpt rho contentsof this consignment are fully and accurately described above by proper shipping Hama and are classifirsd,packed, <br /> umarked,and labeled,and are in all respects in proper condition for transport by hial woy according to applicable international and notional government regulations <br /> If I am a largo quantity generator,1 certify that i have o pr ram in place to reduce the volume and toxicity of wosto generated to the dogroa I have determined to be aconamically <br /> 1 pradico6lo a.d+het I have selected the pradica6lo mothod <br /> yarn <br /> stornde,nr dlspesnl currently available to me which minimizes the present and future throat to human heallft <br /> V) and Fhe environment;OR,if I am a small quantity generator,1 have made a good faith effort to minimize my waste generation and soloct the best waste management method that is <br /> 0!! available to me and that I can afford. <br /> O <br /> Printed/Typed Name+, Sfg tore ' Month y Ya <br /> 6sr R 17. lrons orter•I Acknowled emant of Rocca t of Materials Month D Year <br /> LU A Print T �Mom ` Signature y <br /> N " � c <br /> W <br /> ...�. <br /> ® 0 18. Transporter 2 AcknovA ement at Receipt of Materials <br /> Si nature Month Day Yoar <br /> t Printed/Typed Name g <br /> LU E <br /> V19. Discrepancy Indication Space <br /> F <br /> — A <br /> C <br /> 20. facility Owner or 8 rota Certification fication of receipt of haxordous materials covered b this manifest except as noted in Item 19. <br /> T Printed/Typed Name Signature Menlh Pay Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DT5C 8022A(1/99) Ycllow GENERATOR R.FTAiN', <br /> EPA 8700-22 <br />