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2 <br />Sole of CaCfalio—Emirormenlal PrQWJian Agency <br />Farm Apprord OMS Na. 2050-009 IEpi. 9�30-991 - See Instroctions on back of page G. Oygnmen ot-Ta,dc Se6,+ux., Conyol <br />Pka+o print or Hpe- form daJamd forme oa e✓: r (l?vMchl IypowUer. Soarartrela, CdNarde <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 0027A (1/991 While. TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-21 <br />To: P.O. Box 3000. Socromento, CA 93812 <br />UNIFORM HAZARDOUS-71Ir <br />1. Genwabr's US EPA ID Ne. AA -AW Document No. <br />2. Page 1 <br />bdormation in 96 shadod areas <br />nal raga red by Federal law. <br />WASTE MANIFEST <br />0 t S (0D <br />of 2 <br />]. Genwola/r No.w asi Meiling Addmr <br />TARGET <br />A. S/a4 MCIM614 D«amai N—Iamr <br />l ,.. 22848670 <br />1905 Aston Avenue #100 <br />& s+°~ �n°`�°r' ID <br />:S <br />Carlsbad, CA 92WO 800-60-3220 <br />7 <br />1. Generorals Phone I 1 <br />v <br />5. Trae,porler 1 Campwy Name 6. US EPA 10 Number <br />C Sk" Traroporrers IDs(Ile entd.1 87M <br />SLATE INDUSTRIAL SERVICES, INC. T 514 8 <br />D. Tronsparb(s Phone <br />3 <br />° <br />7. TmnworW 2 Company Name 8. US EPA ID Nunbw <br />E. Slott Tmnporlees fD [Re»rved.J <br />p) 11g <br />F. Tmaspwle's Phone <br />y lo. US EPA a Number <br />& <br />c. 31aea Fadiy, ID <br />t <br />LLU 1 tF(5 C 1 Nil j r r"LIES <br />5486 Tay -For Drive <br />H. F.ciky's Phone <br />> <br />Millington, TN 38053 DM77FIPOI I I I <br />888.724.8W <br />J <br />m <br />11. US DOT Description Undading Proper Shipping Nome, Hazard Clow, and 10 caber) <br />1 2. Coaoinan <br />Na. <br />Type <br />73. idol <br />Ove" <br />16. Unit <br />WI/vd <br />1. Wmre Number <br />X (RQ=1000. Waste Flammable Liquids, n.o.s., 3. UN1933 <br />see <br />erA/olher ours211H <br />G <br />PGI1, (Paint / Solvents) (ERG## 128) <br />G <br />E <br />H <br />X b. Waste Toxic Liquids, Organic, n-o.s., 6.1, UN2810, PGII <br />5p1e DG16 <br />(Diazinon / Maiathlon) (ERC## 153) <br />D <br />O <br />EPA/ UTS102H <br />R <br />r A <br />> TX <br />Waste Toxic, Solids, Organic, n.o.s.. 0. 1. UN2811, PGI! <br />0016 <br />R <br />(Diazinon / Malathion) (ER(## 154) <br />D <br />G <br />6A/�OUTS402H <br />d. Non-RCRA, Non Hazardous Material° <br />NR/NH <br />i <br />(Latex Paint) <br />D <br />G <br />`411UTS2091 <br />J. Additional Dettriplionr For MaMdok Usld Abev. <br />K Hondgng Coda for We M, LWW <br />Allow <br />11a) EI -3 11c) EI -11S <br />a' <br />b. <br />11b) E7-111- 11dj EI -1 <br />G <br />d. <br />15. Spedal tlondlln muruaon+and Addhiosol l.fomalion <br />TARGE B TARTIM leo spreckeis Are IN CASE OF EMERGENCY, CONTACT 3E AT SIX1.451.8W <br />Propos;{! 25768 Mamoca CA 953x6 store cow M RD9) 823-M <br />I6. GINFRATOR'S CIERTIFICAT110K Iher.by dedan d,pldn coMentt or O,+a consiggmwa we tally and accurately dacrlLed;bore br groper +hipping vane end of dmsiNd,podtad, <br />marked, and lob.ld, and era in dl respar+s 1. proper coed' w for han+port by hlghray occorafle b oppllcoblv inwrmiono nohoael gowrrwn.1 reg.Wiom. <br />if I am olarye quaal gegarmor, 1 ordy Oat I hero 0 rem in plan b reduce fie .oler.e and "chy of ..o,la 9—iled b Ike degree( ha.e 6wm;ntd io be eaamml <br />wt +a pwe alld hdxe dura io human hdak <br />d.al he.t " &P391 carrwlly ora"Is to err which mlMrwpm <br />prac6ceble and I .66.4 prad;,.Me ma"47haok.1, stwege, w <br />and +4 emironmew; OR, x l — a sndi quoneiey gentrabr, 1 here mod° a goad WA 49-6 b minimim my —I- 9 --.eon end alae the best --k mo.mgemW meOrod dwt 1s <br />—taw. to " ord deal I con drord. <br />Prinlad/Typd Noma <br />rrgnalun <br />MoNh Day Yew <br />1 <br />17. Trans 1 Ackno le-a.FR .. ipf of-Aw.Ws <br />ypta <br />Sig <br />Maeth Day Yew <br />( <br />0 <br />18. Tr Acbtowled smear of R.cto of Moleriol+ <br />R <br />Pdared/Typed tjomv <br />5 Month Doy Year <br />I. <br />SGtm t- <br />1 <br />1?. Di+cropaocy Indimkon Space <br />F <br />JUN 1 '7 2004 <br />A <br />I <br />I <br />1Z0.F«iii <br />Owner a O rdor CerliBoolion recei a(hoxadav+ reaerlal+ +car or oohed in <br />TYq�aTM <br />31g • -------- <br />5 a <br />DO NOT WRITE BELOW THIS LINE. <br />DTSC 0027A (1/991 While. TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br />EPA 8700-21 <br />To: P.O. Box 3000. Socromento, CA 93812 <br />