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d , <br /> State of California—Environmental Protection Agency <br /> Form Approved OMB No.2050-0039(Expires 9.30-99) See Instructions on back a b. Department of Toxic Substance�ontrof <br /> Please print or type. Form designed for use on elite 112-pits rites Sacramento,California <br /> UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br /> is not required by Federal law. <br /> WASTE MANIFEST f, Ad Cl a 121515161 of <br /> 3. Generator's Name and Mailing Address Sht MOM-we t <br /> GRANITE CONSTRUCTION CO <br /> W) I "'i'Itor's Phone.( yi) - �CA 95376 ' * �` a+ +'� <br /> 603-3611 <br /> cV 5. Transporter 1 Company Name 6. US EPA ID Number # fe'f�e(tis arfos ] '(iTe tst_ Mks— <br /> 0.4 <br /> . 4 . . 1�5tr;lsr '4 0 ICIAIA <br /> . HIM= <br /> CP 7. Transporter 2 Company Name 8. US EPA ID Number Iafctfigi as(aoi�art#wff eservedgg <br /> i i <br /> Q _ <br /> Cn <br /> V 9, Designated Facility Name and Site Address 10. US EPA ID Number (ate Foclf s r° 't r <br /> _ <br /> g CHFIVCAL VAM MANAGEMENT, INC. - <br /> C4ce . 5251 f31.D SKYLINE ROAD Fadtlty�ft��teltn ��� <br /> KETTI ELAN CITY CA 93239 1 C1 A 110101016141610 1171 � ;�, �� T � �� �� <br /> a 12. Containers 13. Total 14 Unit ^ a <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) <br /> V No. T e Quantity Wt/vol Ogg <br /> 11. <br /> Z <br /> �,Oj y �Sy sra� <br /> — <br /> ( 6R(�:CX1tTi: 1<? TY Fi�� il.e/�kFi .`X1 <br /> 3 G ti <br /> N E <br /> co <br /> Eco ar wi i <br /> v R <br /> 04 a <br /> X,,i <br /> Iq A C. <br /> o T ,. °s <br /> o0o O s <br /> R . r <br /> a , <br /> LU 1xit <br /> LU d. � r <br /> Z <br /> LU <br /> V ; <br /> W F y L <br /> N <br /> Z l lildttialioL f145tJ#1stE4nr wM�#fp'r1 1 tFY�A+!4 f PF 4 m s F it f I cff(At{ dRe$ aStgs Listed; �R , <br /> - g�� ��g. <br /> W <br /> f u i V II H I tl i; a. l y 1 Vtiii �i l�u� ai - AN - <br /> Q <br /> O 15. Special Handling Instructions and Additional Information <br /> CHEINTREC mt,r genc.y Response Number (,800)424-9300 VMI' + ofit.ract <br /> Z <br /> W, <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, <br /> Vmarked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. <br /> If I am a large quantity 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 <br /> practicable and that[lave selected the racticable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> N p <br /> and the environment;OR,if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is <br /> 04 available to me and that I can afford. <br /> O <br /> r Printed/Ty ed Name 1 Signal reMonth Day Year <br /> Z e t .pr' a wfy ­­ <br /> 10 1 <br /> ( e 1 <br /> 0 RT 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> Wp P,Oed/Typed Name r_ Signature,. Month Day Year <br /> W F �t \,Pi <br /> U_ 8 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> R <br /> T Printed/Typed Name Signature Month Day Year <br /> w E <br /> N R <br /> U 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> _ C <br /> I <br /> L <br /> f 20. FacilityOwner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> j Printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A(1/99) <br /> EPA 8700-22 Yellow: GENERATOR RETAINS <br />