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State of California—Environmental Protection Agency <br /> Form Approved OMB No.2050-0039(Expires 9-30.99) See Instructions on back nAIIII11kne b. Department of Toxic Substances Control <br /> Please print or type. Form designed for use on elite(12-pit riter. 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 low. <br /> WASTE MANIFEST B A £'3 () rr, 5 6 7 2 of I <br /> 3. Generator's Name and Mailing Address A a Sfat-n fdl9 s '!O f�ts�,u*rk$hlr#mfter f r <br /> ei <br /> GRANITE CONSTRUCTION CO <br /> v - r 41 <br /> e <br /> 30909 S TRACY k LVD1 <br /> `A Vii? $�� }cM e�# R� ml�°�tti It <br /> LO <br /> LO 4. Generator's Phone "UA <br /> N 5. Transp rter 1 Company Name b. US EP? ID Number S 5ste€ }ttsparfu}i eserv` , �r <br /> ff r <br /> LO <br /> / �F �.�+�+' / t O D #rgttspstrtdr'��ttun� # d •�` '•'� <br /> 1 C4 612 <br /> IVO <br /> op 7.'transporter 2 Company Name/ fL J 8. US EPA ID Number Ffl Sia}4{ Cttrlspat}errs f1Y I}se e }dh " t r t"r a <br /> MM I <br /> V 9. Designated Facility Name and Site Address 10. US EPA ID Number $tate Px7t t tty s 1L? 4 <br /> CHEMICAL WASTE MANAGEMENT, INC. <br /> = 35251. OLD SKYLINE ROAD <br /> e0 <br /> i�,ET'II EMA CITY CA 93239 l.: Al � � tr � 6141611 <br /> 117 , M0, <br /> � � # .������ � a <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) 12. Containers 13. Total 14 Unit <br /> U No. Type Quantity Wt/Vol "I ✓t}t p � <br /> ( T f? I l#iAZZ. <br /> ( SR <br /> t � r <br /> c�i E b.o Mata <br /> 00 <br /> EOD <br /> v R <br /> CN <br /> IV A <br /> o T `' <br /> 00 Q - s <br /> gyp, a <br /> R ,,., <br /> LU <br /> ~ d as, Gi ,t rs <br /> Z <br /> 2 Additional Descr�pttoas Fur Msttestafs sled Above " Handitn¢tYodesNFu 41(gsteq�lsted`Aix t .. <br /> Z <br /> LU <br /> Q <br /> 15. Special <br /> p Handling Instructions and Additional Information <br /> a CIIEMTREC; Emergency Resport.e Number t 00)i4 4-9300 VM I V? r,ar,t <br /> Z <br /> Lu <br /> x <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this constgnment 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 byhighway 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 eco Ii <br /> cL 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 /> 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 /> °C available to me and that I can afford. <br /> O <br /> } Printed/Typed Name Signature Month Day Year <br /> ZT I T Transp8rter 1 Acknowledgement of Receipt of Materials <br /> UjA .,..L' feted/Typed Nae/ Signatpre /Month Day Year <br /> Lu P l W°A6 it f .✓A9a ,_e i4l <br /> tl 018. Transporter 2 Acknowledgement of Receipt of Materials <br /> 0 R Printed/Typed Name Signature Month Day Year <br /> T <br /> w E <br /> N R <br /> Q <br /> O 19. Discrepancy Indication Space <br /> Z IF <br /> A <br /> C <br /> i <br /> L <br /> l 20. Facili Owner 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) Yellow: GENERATOR RETAINS <br /> EPA 8700-22 <br />