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a � , <br /> State of California—Environmental Protection Agency ' <br /> Form Approved OMB No.2050-0039(Expires 9-30-99) See Instructions On backe'6. Department of Toxic Substances Control <br /> Please print or type. Form designed for use on elite(12-pile rifer. Sacramento,California <br /> 1Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br /> . <br /> UNIFORM HAZARDOUS is not required by Federal law. <br /> WASTE MANIFEST ,c (; C? to 5 stE9 i� ;' ;� of ! <br /> 3. Generator's Name and Mailing Addresslk fat ant est trvmsnFd*#tt[kt lr N , <br /> GRANITE CONSTRUCTION CO <br /> 3090*9+ S TRACY BLVD <br /> Ln ` RGeC 1 C A 95376 " F <br /> LO 4. nerator's Phone( 2019) 603-361 , <br /> fV 5. Transporter 1 Company Name 6. US EPA ID NumberS#ctteTrstnsporter",41D'jReser4e ' <br /> O r\ 4 ql t� ftgnfZgtiec's Ph4thtt <br /> O 1 <br /> 7. Transporter 2 Company Name 8. US EPA ID Number J E S#pt6"lttn�pprter F fD�R served,, = <br /> t' 1Forlsl?tTfortisYFktsn4t <br /> V 10. US EPA ID Number <br /> 9 Designated Facility Name and Site Address i til i F i e <br /> CHEMICAL IJASTE MANAGEMENT, !NC' <br /> �;2t OLD SKYLINE Rt1t�( Hactff?y„ Pl+ohe � r <br /> YETTLEMAN CITY C;A 932;39 f R t 7 <br /> qq� 12. Containers 13. Total 14 Unit <br /> V11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) No Type Quantity Wt/Vol :j lssx <br /> Z R! 11F *�ltft�l #T^a <br /> a. <br /> r� y <br /> .t <br /> SYS n�•” <br /> E r2l.e . T r } �+ <br /> ft Q#fter t <br /> E <br /> O N b'00 <br /> t1 dYlYii ,a <br /> `o R <br /> � <br /> 00 O <br /> R ,. <br /> piol <br /> Wf� <br /> U ' <br /> wffwr ff#tndlfrt" a'des tot Wasps LISfe <br /> Z 3 Additianaf Descjriptiga s fcr Materials ElatedA bawo g I 3 <br /> $$ a di tlbu rfrl� ou ' a " <br /> Q <br /> LU <br /> l <br /> Z <br /> 15 Special Handling Instructions and Additional Information <br /> a CHEM'IREC° Efffe;.P,eI'l(.;r Respic14se N u Nbe r (8 00 4 24 9;3 V01 1011tA"aCt <br /> Z <br /> W <br /> F- <br /> 16. GENERATOR'S CERTIFICATION: 1 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 /> :_2 If I am a large quantity generator,I certify that 1 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 I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> N 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 /> available to me and that I can afford. <br /> OPrinted/yped Name j Signaforq Month Day Year <br /> Z 6� I., l 1 �t t 'll �' 12 <br /> 12- <br /> �., p,,.� , 0 <br /> W T 17. Transporter 1 Acknowledgement of Receipt of Materials _ 1 <br /> � R S� na!uT). Month Day Year <br /> W A Pnpfed/ d Name <br /> 9 <br /> R <br /> w <br /> O0 18. Transporter 2 Acknowledgement of Receipt of Materials <br /> TR Printed/Typed Name Signature Month Day Year <br /> LU E <br /> N R <br /> (aj 19. Discrepancy Indication Space <br /> Z F <br /> A <br /> C <br /> I <br /> L <br /> 1 20. Faci ity Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> T Printed/Typed Name Signature Month Day Year <br /> Y <br /> DO NOT WRITE BELOW THIS LINE. <br /> DTSC 8022A(1/99) Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br /> I <br />