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nHrmxmm�W Retanion Agency <br /> r � <br /> Dwd OMB No.2050-0039(Express 0.3090 See Instructions on back r igo 6. De mrsoman of Toxic Substances Co.,,.] <br /> Am". Farm dens cmd for use an elite(12pikh)W.wn w. _ Sa,meamro,Cdi.v is <br /> UNIFORM HAZARDOUS I. a erarors US EPA ID No. Manifest Document No. 2. Page I InformoHm in the shaded are. <br /> IF is not required by Federal law. <br /> WASTE MANIFEST D 9 8 1 3 8 7 7 4 2 1 8 O 4 of 1 <br /> r 3. Ge.rmor's Name and Mallin <br /> B Address A. State Ma.Hed Document Number[ r� {��y <br /> LUSTRE-,CAL NAMEPLATE CORP. 9 G 4 2 1 O U <br /> n .41 <br /> 110 E. TURNER RD LODI, CA 95241 8,%taro Generator's iD <br /> n <. Generator's Phone ( 209 334-6263 <br /> ds co <br /> 5. Transporter 1 Company Name 6. US EPA ID Number Transport.,'%10CALIFORNIA SIVENT RECYCLING " <br /> 7 <br /> J <br /> RP. IC 1A I T 10 18 10 10 131112 4 8 sparser' <br /> s Terme 416/BB8 <br /> 7. Transporter 2 Company Name R. US EPA ID Number 7mnsporler's ID i <br /> IO .potter`s Phonei <br /> 9. Designated Faciliy Name and Site Address 10. US EPA ID Number Facility's ID <br /> ROMIC CHEMICAL CORPORATION 1AID1010191415121815171 <br /> i 2081 Bay Road <br /> 'ed< East Palo Alto CA 94303 A D 0 9 4 2 8 7 $ <br /> (� 12. Containe0 13. inial !14. Urm11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12 T 13. To Vol este Number - <br /> �VCF a.HA2A2D00L;s WAS-rf- , Sotr10 , O .o.S, �tsl <br /> 3 c C 1�5 f� — 1 0 Ic SOL-1 0.51� 1,1, I 1cv1�o2Oel -�I EPA/Other <br /> 1 c E — d 5 1 OO"ti <br /> N Is. Scorn <br /> E <br /> N R EPA/Other ' <br /> A <br /> I T C. state <br /> O <br /> R /.her <br /> d. <br /> U <br /> W W 1 A/Other 7 <br /> 1 <br /> K. HandUog Codas 1 ` li»ed Above <br /> I �. b. <br /> s V;, , � <br /> a <br /> ZIS. Special Handling Instructions and Additional Information 7 <br /> O t <br /> Z GLOVES, C-OGGi ES, AND PROTECTIVE CLOTHING. <br /> F CSR PTOMS d 0/7 003 , DOT ERG 0 1 <br /> J 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of dee consignment ore fully and accurately described above by proper shipping name and are classified, <br /> J <br /> packed.marked,and labeled,and are in all respects in o condition for transport b highway accord' to applicable federal,state and international laws. <br /> P Pec proper ^sP Y 9 oy e�B PP� <br /> V <br /> If I am a large quantity generator, I certify that 1 haw a program in place to reduce dee volume and toxicity of waste generated to the degree I have determined he be <br /> J 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 /> ythreat to human health and the environment;OR, H I am a small quantity generator,I haw mads a good faith effort to minimize my wash generation and select the bast <br /> waste management method that is available to me and that I can afford. <br /> V Primed/T1ped Name Sigratum <br /> T 17. Tr Acknowled ement of Racal t of Material <br /> M <br /> Pr inb /Typed Noma SiprwNr Month . <br /> Day Year <br /> 01621 Q <br /> v <br /> 0 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> W i Printed/Typed Name Si mdbre Month Day Year <br /> OI <br /> e <br /> rW 19. Discrepancy Indication Space <br /> Q F <br /> U A <br /> Z C <br /> I <br /> 20. Facility Owner or Operator CertiOcatim of receipt of hazardous materials covered this manifest except as acted in Hem 19. <br /> QQ Primed/Typed Name Signature,► M Day year <br /> P, METER SCHNEIDER/.t(TriN BUTLER/RAY 8011OWSNE <br /> I'I DO NOT WRITE BELOW THIS UNE. <br /> II, <br /> OTSC 9022A (7/92) <br /> EPA 8700-22 Yellow: GENERATOR RETAINS <br />