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AWRALRESOURCE7-185-01 PTE Op <br /> ,AVATION COMMISSION 5�F <br /> Atin,Texs$78711-3087 r <br /> Please print or type.(Form designed for use on elft(12-pitch)"winter.) Form approved.OMB No 2050-0039. <br /> UNIFORM HAZARDOUS 1.Generator's US EPA ID No. Manifest 2. Page 1 Information in the shaded areas <br /> WASTE MANIFEST CAL0001292.02 um nt of s not required by Federal law <br /> USTrS <br /> 3.Generators Name agy?ilinaAdd[9,s I E . <br /> MMANT�`ECCAAtiNV6G CA 95337 Elt Generator'sID <br /> 209 823-9388 9§ ��. <br /> 4.Generator's Phone <br /> 5.Transporter 1 Company Name 6. US EPA ID Number C.State Transporter's ID86119 <br /> SAFETY-KLEEN SYSTEMS, INC ILD 984908202 D.Transporters Phon — <br /> 7.Transporter 2 Company Name 6. US EPA ID Number E.State Transporter <br /> SAFETY-KLEEN ( TG ) , INC. SCR . 000.074591 . F Transporter's Phone916 386-4913 <br /> iRn <br /> d dres 10. US EPA ID Number acility ID <br /> INC <br /> 1722 COOPER CREEK ROAD <br /> DENTON, TX 76 208 H. Facility's Phone <br /> TXD 077603371 940 483-5200 <br /> 11A. 11.US DOT Description(including Proper Shipping Name,Hazard Class,ID 12.Containers Tota1 14 <br /> l unit 1' <br /> HM Number and Packing Group) No. IType ouantity Wt(Voi Waste No. <br /> a' 14ASTE ACETONE - s. <br /> M UTS203H <br /> N <br /> E b. <br /> R <br /> A <br /> T <br /> O <br /> R C. <br /> I <br /> f d. <br /> I <br /> 15.Special Handling Instructions and Additional Information MFST R/T# 98342501 0001-7582-02 <br /> EMERGENCY RESP 800-468-1760( 24 HR ) IF UNDELIVERABLE RETURN TO GENERATOR. <br /> SK CORP AUTH'D TO USE THESE SUBSEQUEN T CARRIERS: 81300, 40355, 41015, 40582 <br /> SKDOT# A: 533 B: C. D: <br /> 16.GENERATOR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name and are <br /> classified,packed,marked,and laballealplacanded,and are in all resper,'s in proper condition for trans 91rI by highway according to applicable international and national <br /> government regulations,including applicable state regulations.: , <br /> It I am a large quantity generator,I certify that I have a program In place to reduce the vol me an oxiciry of waste generated to the degree have determined to be <br /> economically practicable and that I have selected the practicable method o nt,st age,o disposal currently available to me which minimizes the present and <br /> future threat to human health and the environment;OR,If I am a s uantay gener ,I hav made a good faith effort to minimize my waste generation and select <br /> the best waste management method that is available to rn at I ca ffom. <br /> rin d N - Signatu Month' Day Yea, <br /> M96— <br /> O. o. <br /> i ( .T,-17'Transporter 1 Acknowledgement of Receipt of Materials - Date - <br /> n Pr' ,edrryp e - - Signet Month Day Yeas <br /> .a , 1://• <br /> ( P (ltf 6M O Q � t . O./ 10-4/10-C <br /> 0 18.Transporter 2 Acknowledge of Receipt of Materials �4 Date <br /> R e ed Name Month Day Year <br /> E <br /> R <br /> .Discrepancy Indication Space <br /> F <br /> A....... - ...... <br /> c <br /> I <br /> L 20.Facility Owner or Operator:Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br /> I <br /> T <br /> y Date <br /> Printed/Typed Name Signatur �tha Ye r <br /> TV001 (lQ 01/$7Q4902 White-original Pink-TSD Facility Yellow-Transporter Green-Generatoesfi loopy <br /> CMD1A n nnn1n4i09n ` <br />