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<br />GENERATOR'S 4E TION • I hereby declare that the contenptpf this conafpnntent aro�fully and acctxetey deaoribed above by proper shipping
<br />name and are ctass$ieil,apytdcgd, marked: and labeled, and are in�tt respects in prgglrcondition for transport by hiphwag accofdinp to applicable
<br />international and nafibnal povamment regulations. /�9 j/ ,
<br />tf I em a large quantity generator, I certify that I have a program in place to reduce the volume end toxicity of weals generated �o the degree 1 have
<br />determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal curtentiy available to
<br />me which minimizes the present arxi future threat to human health and Op environment; OR, if 1 am a small quantity generator, t have made a good
<br />faith e8ort to minimize MY waste generation and select the best wast an gementet
<br />t od that is available to me and that I can afford,
<br />Pr /Tye ame "' S
<br />:' Month Day Year
<br />R 17. Tra porter t Ackn nt of Receipt df Mat"Is _
<br />A Print d/Typed Nam9 l i y e Month Day Year
<br />N
<br />S' ® s
<br />P 18 Transporter 2 Acknowledgement of Receipt of Materials
<br />TPrinted/Typed Name Signature
<br />E Day . Year
<br />19. Discrepancy indication Space
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<br />1 20 Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. ++i
<br />T Printed/ Typed Name 11 nature
<br />® Si t
<br />Month Day Year
<br />OHS 8022 A (1/ 87)
<br />EPA e7oo--22 <''Okla GENERATOR SENDS THIS COPY TO DOHS WITHIN 30 DAYS INSTRUCTIONS ON THE BACK
<br />(Rov. 9.86) Previous editions ar�l Obsolete.
<br />- A To: P.O. Box 400, Sougmento, CA 93$02
<br />INCASE OF AN EMER r, CY ORSM tfaL 7HE NATIONAL RESP CENTER' ;1.800 424.8802; WITHIN CALIFORNjl1 CALL 1-ti00.8t32 7550
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<br />r ! a s • K dandling Codes for -Wastes Listed Above
<br />b.
<br />�e
<br />c r
<br />t: a
<br />e rtes ; yam?'
<br />f c d...
<br />t
<br />16. Special Handling Instructions and Additional Information
<br />�r.�o A��.epr,,�G.><T�. f.Z"d6 rCLOi�• ... v �j ®.
<br />.. I
<br />GENERATOR'S 4E TION • I hereby declare that the contenptpf this conafpnntent aro�fully and acctxetey deaoribed above by proper shipping
<br />name and are ctass$ieil,apytdcgd, marked: and labeled, and are in�tt respects in prgglrcondition for transport by hiphwag accofdinp to applicable
<br />international and nafibnal povamment regulations. /�9 j/ ,
<br />tf I em a large quantity generator, I certify that I have a program in place to reduce the volume end toxicity of weals generated �o the degree 1 have
<br />determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal curtentiy available to
<br />me which minimizes the present arxi future threat to human health and Op environment; OR, if 1 am a small quantity generator, t have made a good
<br />faith e8ort to minimize MY waste generation and select the best wast an gementet
<br />t od that is available to me and that I can afford,
<br />Pr /Tye ame "' S
<br />:' Month Day Year
<br />R 17. Tra porter t Ackn nt of Receipt df Mat"Is _
<br />A Print d/Typed Nam9 l i y e Month Day Year
<br />N
<br />S' ® s
<br />P 18 Transporter 2 Acknowledgement of Receipt of Materials
<br />TPrinted/Typed Name Signature
<br />E Day . Year
<br />19. Discrepancy indication Space
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<br />A f
<br />C
<br />I
<br />L
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<br />1 20 Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. ++i
<br />T Printed/ Typed Name 11 nature
<br />® Si t
<br />Month Day Year
<br />OHS 8022 A (1/ 87)
<br />EPA e7oo--22 <''Okla GENERATOR SENDS THIS COPY TO DOHS WITHIN 30 DAYS INSTRUCTIONS ON THE BACK
<br />(Rov. 9.86) Previous editions ar�l Obsolete.
<br />- A To: P.O. Box 400, Sougmento, CA 93$02
<br />INCASE OF AN EMER r, CY ORSM tfaL 7HE NATIONAL RESP CENTER' ;1.800 424.8802; WITHIN CALIFORNjl1 CALL 1-ti00.8t32 7550
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