Laserfiche WebLink
a <br />< . <br />state G dorm Environmental Prot«tfoo`A®e�Y S@@ InfTPuetl®nf 4h back Of Istag@ 6. Deportment of toxic substances <br />Form Appn d 8 No. 9 (Expires 9.30}94) Socromeoto, California <br />Please print r Form designed for use on elite (l?pitcA writer. <br />rotor s US EPA to No. Manifest Docum 2. Pugs 1 Information in the shaded areas <br />U (FORM HAZARDOUS is not rpqufred by Federal low. <br />Ar Q 7 i of <br />ASTE MANIFEST <br />�MiirifFbstboarmeni�� <br />G Siesta: FoaRy's ID / <br />HC es <br />12. Containers 13. Total 14. Unit <br />No. T e Guonti Wt/Yol <br />U 1011 T IT I l Ao i3 <br />Z 15. Speciol Handling Instructions and Additional Information <br />APPROPRIATE PROTECTIVE CLOTHING JOB SITE: <br />Z "EMERGENCY CONTACT®(209)667-6692'° 134 12TH ST. <br />= SEE E.R.G. PAGE 31 MODESTO, CA <br />r <br />J16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of the consignment are fully and accurately described above by proper shipping name and are classified, <br />4 packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable Federal, state and international laws. <br />V <br />If 1 am a large quantity generator, I certify that 1 have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br />economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future <br />rLthreat to human health and the environment; OR, if 1 am o small gvanKy generator, I have made a good faith efF to minimize my waste generation and select the best <br />V)it <br />waste mono ement method that is available to me and that 1 can afford. <br />_. v_.. <br />ce <br />O <br />3. Generotor's Name and Mailing Address - <br />o <br />17. Trans orter 1 AcknowI d ement of Recei t of Materialsof <br />STANISLAUS FOOD PRODUCTS <br />Wx <br />U <br />H <br />P.O. BOX 3551, MODESTO, CA 95352 <br />N <br />S <br />p <br />a <br />4. Generator's Phone :?09) 522-7201 <br />to <br />00 <br />O <br />US <br />5. Transporter 1 CompanyNome 6. US EPA ID Number <br />O <br />o? <br />Si <br />OR CAL OIL C I AD 19 1 8 4 <br />e <br />a <br />7. Transporter 2 Company Name 8. US EPA 10 Number <br />U <br />U <br />19, Discrepancy Indication Space <br />W <br />N <br />Q <br />F <br />Q10. <br />Z <br />n <br />A <br />9. Desi d Fili fess US EPA ID Number <br />F.'EF 11798 IcEMN SERV ICEite <br />o <br />n o <br />L <br />1 <br />13331 N. HWY. 33 <br />-{ Q <br />T <br />Y <br />PATTERSON, CA 95363 C A f? 8 1 <br />�U <br />11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) <br />n Z <br />J <br />NODI—RCRA HAZARDOUS WASTE LIQUID <br />3 <br />G <br />(WATER & OIL) <br />o <br />00 <br />E <br />N <br />b <br />c0 <br />E <br />N <br />R <br />A <br />0 <br />T <br />O <br />C. <br />ce <br />R <br />w <br />- <br />Z <br />d. <br />LU <br />U <br />w <br />N <br />for Maronbtk l 4ed Aha ` ` �� sir`- °-s <br />a• .. ' <br />Opescreptions <br />CL <br />7 <br />` <br />N <br />i'�1Vt OTTOK,°WA T <br />ac <br />ISI 5` `T <br />q-T,gaw„ <br />G Siesta: FoaRy's ID / <br />HC es <br />12. Containers 13. Total 14. Unit <br />No. T e Guonti Wt/Yol <br />U 1011 T IT I l Ao i3 <br />Z 15. Speciol Handling Instructions and Additional Information <br />APPROPRIATE PROTECTIVE CLOTHING JOB SITE: <br />Z "EMERGENCY CONTACT®(209)667-6692'° 134 12TH ST. <br />= SEE E.R.G. PAGE 31 MODESTO, CA <br />r <br />J16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of the consignment are fully and accurately described above by proper shipping name and are classified, <br />4 packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable Federal, state and international laws. <br />V <br />If 1 am a large quantity generator, I certify that 1 have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br />economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future <br />rLthreat to human health and the environment; OR, if 1 am o small gvanKy generator, I have made a good faith efF to minimize my waste generation and select the best <br />V)it <br />waste mono ement method that is available to me and that 1 can afford. <br />_. v_.. <br />ce <br />O <br />Print d/Typed Nome Signa <br />U <br />17. Trans orter 1 AcknowI d ement of Recei t of Materialsof <br />T <br />Wx <br />U <br />H <br />Printed/Typed Name Signa re <br />E" — u CT <br />Uj <br />S <br />p <br />a <br />nowled ement of Recei a of Materials <br />US <br />T <br />Printed/Type Nome <br />Si <br />LL <br />Q <br />e <br />a <br />19, Discrepancy Indication Space <br />W <br />N <br />Q <br />F <br />U <br />A <br />L <br />1 <br />10. Facility Owner or O rotor Certification of recei of hazardous materials covered b this muni <br />T <br />Y <br />Printed/Typed Name C Signatur n <br />Month <br />Month Day Year I <br />Montle Day Year <br />DO NOT WRITE BELOW THIS LINE. 4G <br />White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />DTSC 8022A (7/92)- To: P.O. Box 3000, Socramento, CA 95812 <br />EPA 8700-22 <br />