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TRANSCRIPT
XK.0011 •"State of Citlifornia—EnvironmentaLProtection Agency
Form Approved OMB No. 2050—0039 (Expires 9-30-96) Please print or type. Form designed for use on elite (12-pitch) typewriter.
See Instructions 01
SFUND RECORDS CENTER
88225766
L
SFUWl) RECORDS CTR1-^,
J 5169 00003 | Department of Substances Control
Sacramento,. California 1
UNIFORM HAZARDOUS WASTE MANIFEST
1. Generator's US EPA ID. No. Manifest Document No. »"
C| A\ P | |S%'| S[
2. Page 1
of !
Information in the shaded are'as
is not required by Federal law.
3. Generator's Name and Mailing Address 1^)5 ^ faj| A. State Manifest Document Number ..
IS HAwPtoAX /r ir, (sffc-*/) ' ' J f O£04
4. Generator's Phone (H &) V' TObo^ tG<T
5. Transporter 1 Company Name 6. US EPA ID Number
B. State Generator's ID
I I I I I" I C. State Transporter's ID
7. Transporter 2 Company Name
•Sj? '£-5: D Transporter's Phone V
8. US EPA ID Number .
9. Designated Facility Name and Site Address . -Ho.vitc^.L errW£»<r
I OCb JV.YUAVf bqL.
ii 1^' C i t y OK
10. US EPA ID Number
|C \A |T"lO io lO | & | Y\(e I il | 7
E State lransporter's ID
F. Transporter's Phone
G. State Facility's ID
H Facility 5 Phone
L '• - S • !
Cips y
11. US DOT Description lincludmg Proper Shipping Name, Hazard Class, and ID Number) 12 Containers
TOT rH t'J ^ S fr~ ' Jc l i t> rij C 5 I ' / ' •
No _ Typ_'\.
13. Total
Quantity
14. Unit
Wt Vol I. Waste Number
a. JAW "TOT
(.WV CC'SJ:Ae''hA' :l7i^ « ;. AJA ioh.iai
b T C p f i J 8 y_ 6(1
EPA Other.
State
EPA/Other
State
EPA/Other
State
EPA/Other
fitsiisiis for Materials Listed Above
15. Special Handling Instructions and Additional Information . ' , / ,
Vi <L*nul(*Wc.i , /tlS/feWft • HIST-7VV-2-o&c
CtA.Tip<c4-Tr ••of.
t-C-y- tz>l6\
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, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulations.
• . * ' • t • • _ . (
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 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 arid the environment; OR, if I am a small quantity'generator,. ! have made a good faith [effort to minimize my waste generation and select the best
17. Transporter ]. Acknowledgemenfof* Receipt of Materials // . r" *•-> /L\
gL. Signature ij/ //f
( 'n i T\%
18. Transporter 2 Acknowledgement of Receipt of Materials ..syS' * *"
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
A]
20. Facility^ Owner or Operator CertificotiofTbf receipt of "hazardous materials covered by this manifest except <>as noted in Item 19
Printed/Typed Name^ Signature Month
/ S
DO NOT WRITE BELOW THIS LINE.
DTSC 8022A (1/95) EPA 8700—22
Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. (Generators who submit hazardous waste for transport out-of-state, produce completed copy of this copy and send to DTSC within 30 days.)
.4>tote.:ofr-Galrfornia—Environmental Protection Agency ' Form/Approved OMB No. 2050-0039 (Expires 9-30-99) . i'.T'*'"'>' ,>
Please print or type.| Form designed for use on elite ( 1 2 - pitch) ' typewriter. ' ' " A ' "
See Instructions on back of page 6. Department of-Toxic Substances Control
- SacramentoVCaliforriia
i UNIFORM HAZARDOUS
> W^STE^ MANIFEST
1. Generator's US EPA ID No. j Manifest Document No.
' ••• 'I A • Y
2.14 P^'isf.iffio if 1J 5 14 /|9 -\k
2. Page 1 •
" 1 o f j ' :
Information in'the-shaded areas
•is'not-required by Federal law.
3., Generator's Nqme'and'Maili'ng Address {J£ A.'-StatefManifest Document Number
4. Generator's Phone (wj kjCj , •£}
RAAvictsCi? OA B 'State Generator's ID
5. Transporter 1 Company Name
0. /-,• / —>— A
M/
6 . US EPA ID Number C State-Transporter's ID
7. Transporter 2 Company Name
/jsJu/A ei \c.\d\/:Ac>\'%\'5 l<o\&\3 T \x£ ' l M I " r ' " - P ./ . yy . > < / f ;
. US EPA ID Number
U
E. State Transporter's ID
F Transporter's Phone
LQ^~
CT)|
Ljo CO±
9. Designated.Facility Name and Site Address , *10. US EPA ID Number
\\Jdsre m
ssdstol oSKT11
k Fttt >. /Sm a n/ c / 7~y. (7 rf* /I" id \i"7? \o\P^> I yid> ''1/17
Gl • State' Facility's ID ' '•
fk! £h^-U_Z_ H 'Facility's Phone
I <va*4<^ * .u
C\t 1 1. US.D,OT Description (including Proper Shipping Name, Hazard-Class, and ID Number)
12. Containers
No.
P*""!
a>| G f
a Wsri#, rt.es,
ivt" Cjssf /A/'tyttFt) Soil4/<4 Jo7*^ fta JJ-i-
o h .It
Type
ft-tr
' 13. Total'
Quantity
14. Unit
Wt/Vol I Waste Number
State
b ' i l
A9:k?-VB y
EPA/Other
a VQi-0i i
Stote
EPA/Other
State
V
I ^ i i L< . [ 1 c L Vt l« i i l L i i i \ l c < i 1 • '•j" K Handling'Codes for Wa ^|§%lfSifi|» 'mm
i»S»
o 15. Special Handling Instructions and Additional Information ,. ^
-£M'- ttM- ZrhPO&UW #£sfi*JS£ : TFli>"^ra\ie. W-.J*so©'
W "iM*" '1 6. GENERATOR'S CERTIFICATION: J hereby declare that the contents of this consignment are fully and accurately described above by-proper shipping name and are classified: packed,
. ' marked, and labeled, and are in all respects in proper condition for transport by highway'according to applicable international and national government regulations., v- , ; •'
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 -practicable and that I nave selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human-health and the environment; QR, 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 ' available to me and that I can afford. #' , 4 ^ A *
A. Printed/Typjd Naj yped Name \
J—
Signature
I I i t i oTh fW
Day»
o 1 7. Transporter 1 Acknowledgement of Receipt of Materials
Pririted/Typed Name ,
RnfoP \4 lU tPd
1 8. Transporter 2 Acknowledgement of Receipt of Materials
Signature /J Year Month Day
Printed/Typed Name Signature Month Day .
19. Discrepancy Indication Space
vL 20. FacilityjQwner or Operator Certificotion'of receipt obhazafdous materials covered by this manifest except as noted in Item 19,
Printed/Typed Name. Signature' Month Day Year—*
DO NOT WRITE BELOW THIS LINE.
-DTSG;8022A (4/97)' EPA 8700—22
Yellow; , TSDF SENDS THIS' COPY TO GENERATOR WITHIN 30 DAYS. (Generators who submit hazardous waste for transport out-of-state, produce completed copy of this copy and'send to DTSC within 30. days.)
State**of cfalifornio-1—Environmental Protection Agency • • ' . • '£$ '7 '
- / / / •
Form(Approved OMB'No. 205(WK)39^ (Expires 9:30-96)' -,l! ' ' 1 . S©€ Please print ortype". Form designed for use on elite (J2^pitch) typewriter.?^ '•; ; 1
See Instructions; on back* of page. 6. ' * Department .of Toxic Substances Control ' / Sacramento, California •.
UNIFORM HAZARDOUS WASTE MANIFEST
1. Generator's US EPA ID No.
-V " v'. ' I 2 |^rPj<?|6 pug-
•v. . Manifest Document No. ,
m
)/l. Page 1
of *1' A
Information in. the shaded areas .is not.required;by'Federal law.
.3. Generator's Name and Mailing Address US tftA, (L&k JCW *1 • W•• IfZfricH
.' -.is {sr (sfe-i)
• ,» • , f/Hvcisci? X4 ts-io' 4. Generator's Phone ( . . "Ss-
A State Manifest Document Number ^ SL- ^ a
5 o £ i uOIo
5. Transporter 1 Company Name 6. US EPA ID Number
• • . ^ r r ^ ' / f \ i l \ d \ O & \ 2 \ 0 \ / ) \ 3 \ & \ 4 \ < 2
7. Transporter 2 Company Name '• " ^
9. Designated Facility Name and Site Address ttiem <-4L ^.'niTS rlr^-lft^Vnt-WT
?Si5i s^yc/A,r Kz.
i<L:niE"^ C l r-/ 61 "i 27-J4
10. US EPA ID Number
B State Generator's ID
I I II I I C. State„Transporter's ID
D Transporters Phone \
b State Transporter's ID
F Transporter's Phone
G State Facility s ID
• ' / ; ?•? • • • • ' /
acuity s J
" K l j r | o i o | c i f c . | i f | t p [ r | i P
H Facility's Phone
Zc -i
11. US DOT Description (including Proper Shipping Name, Hazard Class; and ID Number) 12. Containers
No. Type
13. Total Quantity
a. . .wis re, soLapt <V.OA, 0> pr , 1 ; P l O l ' J KiT" te-oj \ iS
b. State
EPA, Other
State
EPA/Other
State
EPA, Other
J. Additional Descriptions for Materials Listed Abovo;
' " i - L . • ' < L r * J I - i ' C I — " i V ' i r - J
K Handling Codes foc-Wastes
'§pm'<y
Listed Above
15. Special Handling Instructions and Additional Information
tli l-iotr'A £,hUZ&?,\:c V /V'u-', Tc • /'• > v-3oa.fi
b„-
'l.t&lhiLi b
16. GENERATOR'S CERTIFICATION:: l<hereby:declare that the contents of thisconsignment.are fully-and accuratelydescribed above by proper, shipping name and 'are'classified, > . packed, marked, and labeled, and are in all respects in proper condition for^ transport by,highway-according to applicable international and national government.regulations.
If I dm a large quantity generator; I certify that I have a program im place to reduce the volume and toxicity of waste.'generated to the degree I'have determined to be
.economically 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 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 w a s t e m a n a g e m e n t m e t h o d t h a t i s a v a i l a b l e t o m e a n d t h a t I c o n a f f o r d ; / t % . A . ' & x f \ A *
Printed/Typed fllame
, - X \ ' jJfA • J Signature
w I Month \ Day ^
/ I 3 J 0 I 9 \ j
Year,
17. Transporter 1 Acknowledgement of Receipt of Materials*
Printed/Typed Name ' j )
' /JCU /-i JaJ <9
Signature I
Month Day Year
1/13"
18. transporter-2 Acknowledgement of Receipt*of Materials /£>. Printed/Typed Name Signature Month Day Year^
19. Discrepancy Indication Space
/ n 20. Focility^Owner or Operator Certification'of receiptyof hazardous materials covered by this manifest except^as.noted in Item 19.
Printed/Typed Name/ Signature Month y
Day ^•Year.-
DO NOT WRITE BELOW THIS LINE.
DTSC 8022A (1/95):
EPA 8700—22
Yellow: TSDF SENDS^ THIS COPY TO GENERATOR WITHIN 30 DAYSj (Generators who submit hazardous waste: for transport out-of-state,
•. produce, completed copy of this copy and send to DTSC within 30 days.)
J • <•* 3 J ' Stote'df Cfalifornia—Environmental Protection Agency """** /,
Form Approved OMB No. 2050-0039 (Expires 9-30-96) * 1
Please print or type. ^ Form designed for use on elite (12-pitch) typewriter.
See Instructions on back of page 6.
' V ' • . • Department of Toxic Substances Control
Sacramento, California
Manifest Docurr\£nt_N6. ' /,< •'•jf_ UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator's US EPA ID No.
C \<^\ P|Q| [£| S |31
2. Page 1
I of |
Information in the shaded areas
is not required by Federal law.*
3. Generator's Name and Mailing Address US itW^
S4\i c/\ 4/tCi*~ • 4. Generator's Phone ( * l5) QC*
A. ^ State. Manifest Document Number •
«QM
B. State Generator's ID
5. Transporter 1 Company Name -6. US EPA ID Number C. State Transporter's ID
D. Transporter's Phone| i n o ^ f L
7. Transporter 2 Company'Name 8.-US>EPA ID-Number E. State .Transporter's ID **•>
F. Transporter's Phoiie
9. Designated Facility Name and Site Address C HOI1 ix4t iflJASnr /-MaM 6e*J£wr
r>! i\ b/i
10. US EPA ID Number G. State Facility's ID
1j&p&p&rt&srtX.
w c j r y C 4 c ) J Z S ' v |C|^|T |o| op-jfo |V \4> \ 11V-17
H. Facility's Phone
17 if
11'.- US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number)
a. rv-i£A,2*bous ;
£&6r • Soj/*);.tji: Aj^pJX ' ^tWL / i r y
-• - f
12. Containers
O 1O.11 '
Type
,b .iT
13. Total Quantity
O i O i o i i - S
14. Unit Wt/Vol I. Waste Number
State £. f I * * - • ;
EPA Other
State
EPA Other
State
FPA, Other
State
EPA 'Other
J. Additional Descriptions for Materials Listed Above
, k-> Aft;**#*:ti €wc\ % i
K * Handling Code's .fprpWastes Listed Above
15. Special Handling Instructions and Additional Information LmUlbLAjcy V-lSftzAis£ Jbb^Hc-.xfer
C&LnP>i4rt ^ bfrPoMb .
'b&T" e&£* ' '#:3 |
A/<SMdt>L : H>S- ?Vy. 2.0o<?
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, marked, and labeledyand 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 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 practicable and that I hove selected the 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 small 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 con afford. . /^\ /If) | lA A I
17. Transporter 1 Acknowledgement of Receipt of Materials
Printed/Typed Name ... r*>
> H e , 3 « ! / ? / )
/ Ta ioTY i f " ?
Month Day., _ Year^
/ l - ? \ 6 0 I ? J
18. Transporter-2 Acknowledgementof Receipt of Materials
Printed/Typed Name Signature Month * Day Year*
19. Discrepancy Indication Space
/
X /I 20. Facility/'Owner or Operator Certification of receipt of hdzordous materials covered by this manifest except .as noted in Item 19.
Printed/Typed Name Signature Month Day Yearv,
DO NOT WRITE-BELOW THIS LINE.
DTSC 8022A (1/95)
EPA 8700—22
Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. (Generators who submit hazardous waste for transport out-of-state,
j produce completed copy of this copy and send to DTSC within 30 days.)
' - 1 ' rPJMJ" P -ff
*of California—Environmental Protection Agency y\ t (J $ £?/£*% TT > Q • ' ' Form ApproWd OMB No. 205CHH>39( (Expires 9-30-96) * -A / " C& See Instructions On bdCK OT page 6. Please print or type. Form designed for use on elite ( 12- pitch) typewriter. * . . . . . . M . . .
rStote
y\
Department of Toxic Substances Control • , Sacramento, California
UNIFORM HAZARDOUS WASTE MANIFEST
1. Generator's US EPA ID No./> ID No.xy
C|/^| P|O[Of(0|O|S5|"5i^ fS |&1 &\ 15^.
Manifest Document 'Njor^-
O I /
3. Generator's Name and Mailing Address U5 £' y iUzXz 4 C?W . tQiAfJOirf
1<$ K>M sr (jPh -to)
SAivl c1Hior 4. Generator's Phone (H iy) ©CO
2: Page 1 -
i I of
Information in the shaded areas is not required by Federal law.
A State Manifest Document Number
96270383
5. Transporter 1 Company Name 6. US EPA ID Number
B State Generator's ID
" M i l l 1 C State Transporter's ID
!_L
7. Transporter 2 Company Name
"V .in, \C\rifl p |<3|JM*|J|6|f I? D Transporter's Phone rj , t -
& 1 * S> t 8.„US,EPArID Number E. State Transporter's ID
F Transporter's Phone
9. Designated Facility Name and Site Address
Crt£iWlt4L IWUJ'fO.cm&ntT
?5z.s <• oub >ilytiue' "brt.
^Lme- wu-j c iT-y c\ iZ 's c<
10. US EPA ID Number G State Facility's ID
CH ZZp&f.
K ^ m ' , i o | o i f e | ' - i | f e | i | | | 7
H. Facility's Phone .
"t&'{ -?\rt *^711
11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number) A . x
WU rr~ , Sol.• A/.C.S. '
(bbr* CcwvAww/wvT-Rsr& Soi 3/ ^ ) i)A0o~rir fih jjT
12. Containers
No. TVPe
13. Total
Quantity
14. Unit
Wt/Vol Waste Number
State
Q|Q 11 )>\T k 11
0 | O | Q | l [ 8 EPA/Other
State' 'l-
EPA/Other
State .
EPA/Other
State
EPA/Other'
J ^Additional Descriptions for Materials Listed Above
u" /' yf-
K. Handling' Code? for Wdsf^""Listisd~Af>ove* *
b.
15. Special Handling Instructions and Additional Information *
2.M VMvi. §.vvtfa.6f../Jcv V£ mjr-7\'v-7cce
CL-Art-^da-rc .• i> atopic f2-£Qt/trtx& bcr i&-<* .
15. 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, marked, 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 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 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 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 ovailable to me and that I can afford. y*""V_AjV__| \f \ A \
Printed/Typed Name
/ I 'M . i rw ih r t 1 i fp f i t IOT? \ f f 17. Transporter 1 Acknowledgement of Receipt of Materials J
(t-Printed/Typed^N ame pedfName Signature!
£ Month Day^ ^Year„
I 12.1 or? | 18. Transporter 2 Acknowledgement of Receipt of Materials •
Printed/Typed Name Signature Month Day Year
19. Discrepancy Indication Space
/ 20. Facility Owner or Operator-Certification of receipt of hazardous materials covered by this manifest"except-as noted in Item 19,
Signature Month Day Year
DO NOT WRITE BELOW THIS LINE.
DTSC 8022A (1/95)
EPA 8700—22
Yellow: TSDF SENDS THIS COPY TO GENERATOR WITHIN 30 DAYS. (Generators who submit hazardous waste for transport out-of-state, produce completed copy of this copy and send to DTSC within 30 days.)