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<br /> 8n_ Aaaa, NMINi-AL-AL101111007 Jun • 5 . 20037 : 29RMtGla r Environmenta
<br /> No 0648 P . 3
<br /> Form Ap{rwad OM$Na.2®®0- 39(lxplru P•E0�49) See Instructions on back
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<br /> 9oaomonlo,California
<br /> UNIFORM HAZARDOUS i' Qaaarar�s Us EPA to No. Mord st Doavmenl No. 2. Page 1 infonlfattan In the eho ed degas
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<br /> WASTE MANIFEST' (� t "� of
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<br /> � 4. Omerafor's Phone � .• 11,1
<br /> 6, Tronspartar 1 Company Name 6, US EPA ID Number C, $Mte Trdnsportat's ID .1
<br /> 0 077
<br /> Troasparter"s Phone'-—TlibTFL1971151
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<br /> CROSBY AND OV�RTON, //
<br /> ~' 1630 4f. 1778 ST Hr�FaaIIIVF P rt1a; ''
<br /> 11. UG'DeT Description(radadleg Prepar shipping Name,Hazard On!,and ID Nvmbw) 12. Cotudinarn Iia. Total ts, Unil
<br /> No. I Type ®vonM WI/Vol L 44ala Nvmbor
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<br /> RQ WASTE FL ABLE LIQUID, N06r 3r UN1e P ® ) (�0
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<br /> 15, apodal Handling tnAlrvclfoni and Addiltonal Informa"Oh
<br /> MGENCY PHONE a 81 all 458-3636
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<br /> 16. OfNEAATOIe'S CEIt11iICATIONI I horotle deelore that the Benton's OF.kla eonstgnmentore Fully and axurotelt desrlbed above Irl.proper shipping ome and are dossiHed,peeked,
<br /> mammal,and Iobelod,end ora in od napsrais In proper condition for Ironeport by highway according to applirea`le inlornuilonol and national gor6rnmbm regulations.
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<br /> Kletfy of waste gorated to the degree i have ►errftined ro bo.00nemlaaft�
<br /> prualiauble and Ilial 1 hoselsr�d Ihhao practicable method a Irsaiment,ssarago,at d It al eurronlY�ewdlldble to me whkh minlmizaaa
<br /> s the prant and future threat to human heolr
<br /> and the eevironmany OR,IF I am a small quanitty genoraior,I have mode a and Faith oflo►I IN mtn(mta my wosla p4wot►on and select Iho bel wools monagarml malhed Thal IA
<br /> available to me and Ihol 1 can aFFerd.
<br /> PriMed/Typed;N�me algnahrra Month Day Yaa�
<br /> 17. Trans erler I AgIrnawlado4moril of Rdeal P of Malarlals
<br /> Art Ped/Typed Name Signe re Month Doy Yaar
<br /> t,� a .16.,Tronsageldr 2 Atloww6diMmenta Rasai t of Malarlals
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<br /> DO,N T Wr9ITE 8 OW THIS LINE.
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<br /> DTIC 8022A(1/00)
<br /> EPA 6700-22 6toon: TRA145PORTER RtJAIN$
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