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State of Ca ifornio—Environmental Protection Agency Form Approved OMB No.2050-0039(Expires 9-30-99) See Instructions on back j9e 6. Department of Toxic Substances Control Plaase print or fyphb. form designed for use on elite(12-pitch, ..,:writer. Sacramento,California UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas is not required by Federal low. WASTEMANIFEST r A L t� 0, 1 8 1913 g x x x x of ._ 3. Generator's Name ail Add"" A. State Manifest Document NumberU5RAMARC. ITN jT 68 W T&IRD S 2 1704737 MAIFL.FIEL it tCA94 533 B. State Generator's ID A. Generator's Phone('J ) ) �� _C �(1 N 5. Transporter I Company Name 6. US EPA ID Number C. State Transporter's ID[Reserved.] to ao F4.1ter ReeyCI ng Se V ices, Inc, JA Ls 1 11 i 1 4 4 4 111 1 D. Transporter's Phone a0 7. om an Transporter 2 CN P Company 8. US EPA ID Number E. State Transporter's ID[Reserved.] J F. Transporter's Phone V 9, Dpesignated Facility Na a and Site A dress 10. US EPA ID Number G. State Facility's ID Fi LL�t �+.«c ai : ncr Se vioes, Ir,c. Cr Z 1801 A. Monte venin O Rd.al*or CA 92 16 C � � � � 6 4 � Q � � i H. Facility's Phone 7 7 LL (909)4..1-2Old J 12. Containers 13. Total 14. Unit V 11. US DOT Description(including Prope Shipping Name,Hazard Class,and ID Number) No Type Quantity Wt/Vol I. Waste Number :a6 Z aNcm—R17R.A zar L s ,caste licruidIE �d t- 3 0 - c I. o N b.'+��n- -� tar 4r Wante Sol—L , 00 act E v R � '� pf -� Fer C14 A p T C. + . / State 00 0 R 4r f "f FpeTr k�++`kf. � EPA/Other W !N ZASw [ { JJ p� y1 d S +/Iel�oEs r+ fr'}f f1tf ' N State VQUA, P `+ EPA/Other LU Bove •F. r,a t�T` K. Handling Codes for Wastes Listed Above n 1•.sQ+� Lr rl,G 8 4 4,'1 1VU44s" S i� a. b. ( 6 A) " 13) es v Q u.T- L-r) 1`f 4-T EIZ—r u 5 5 , k'3 v J C. d. Q Z $ s�eciay ndl lriifru3t scs ag2J fWrbfllrtfdfilatiotf I ry t Pyr i O �F4A Q �� 153 11TH ST Z 24 cur Emerge cy Re ponse # (909) 721-2038 TRACY, CA W 16. GENERATOR'S CERTIFICATION: I her by declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, Umarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. If I am a large quantity generator,I ce rtify 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 V) practicable and that I have selected th practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health and the environment;OR,if I am a s II quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford. O } Printed/Typed Name Signptyre j �. Month Day Year Z v 't I r ,y 1 t/ j3w T 17. Trans orfer 1 Acknowle ement of Rec?iPt of Materials /1 R LU B Printed/Typed Name i Signatyre 1 f j J' Month Day Year O0 18.Trani orter 2 Ack�wled mens of Rec tipt of Materials T' I I L T Printed/Typed Name Signature Month Day Year w E N R Q V 19. Discrepancy Indication Space Z F A C I L 1 20. Facility Owner or Operator Certificatior of receipt of hazardous materials covered by this manifest except as noted in Item 19. T Printed/Typed Name Signature Month Day Year Y DO NOT WRITE BELOW THIS LINE. Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. DTSC 8022A (1/99) (Generators who submit hiazardous waste for transport out-of-state, EPA 8700-22 produce completed copy of this copy and send to DTSC within 30 days.)