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State of Cclifomic—Environmental Protection Agency,Form Approved OMS No. 2050-4W9 (Expires 9-30-991 SO& Instrudions7off- bad�ftagelr, Departmero of I Toxic Substances co,Nease print or type. Form designed for use on elite 112 -t�pimw . W Sacramento, California;UNIFORM HAZARDOUS (ionerator's US EPA ID No. Manifest Document No. 2. Page I Info.—A orr in the shaded armsis rot required by Federal law. - 6 19-19 10 1WASTE, MANIFEST JA IC 10 10 12151514 j7 16 10QCW ASTON AVE SUrFE 100CARLSW CA 9M SlotaGan"OsC14 5. Transporter I Company Name 6. US EPA ID NumberLO IC SlatwTronsportees 1000IC IA ID 10 121812 1717101316CP I7. Transporter 2 Company Name 8. US EPA ID Number ri ID (BiLldvI Aft—MoU 9. Designated Facility Nome and Site Address 10. US EPA ID NumberDEMENNOIKEROOON:;� 11. US DOT Description (including Props, 12. Containers 13. Total 14. UnitU r Shipping Nome, Hazard Class, and Ib Number)No. Type QuantityNON -RCRA HAZARDOUS WASTE, LIQUID (OPLY WATER)ccCNcc 0LULU0 15. Special Handling Instructions and Additional InformationUSE PK EMERGEWY CONTACT. MEL HARPERSITE: J-110 WEST TURNER, LODI, CA 95240 Pr 0 ler . -4 A 1r16. GENERATOR'S RTIFICATION: I hereby declare that the contents ofWs consignment are fully amarked, and I'bCelled' nd occuraltde- per ship ing name and are classified, packed,< and are in all respects in proper condition for transport by highway according to pp i ableri nation7government regulations.Iflom I generator, I certify that I have a program in place to reduce *the volume and toxicity of waste generated to the degree I have determined to be economically(n a 'a' e "Tave selected the practicable method of tr stora swrItcurrentl mailable to me which minimizes the present and future threat to human health0- practicable and7at Iand. the environment; OR, if I am a small 2Cie I can afford. quantity generator, to minimize my waste generation and select the best waste management method thatlis0 crvai6ble to me and that6� r ted/Typed Nome ture JJjnth Day Year17. Trans rter I Acknow lament of Receipt of Materials PA Printed/Typed Nome Month Day Year0 18. Transporter 2 Acknowledgement of Receipt of MaterialsT Printed/Typed Nome Signature Month Day YearUjU F 19. Discrepancy Indication Space20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.T Signature Month Day YearPrinted/Typed Nome DO NOT WRITE BELOW THIS LINE. oTScomsA(//vv EPA 8700-22