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7-las-I>1 <br /> Farm Approved.OMB No.2050-0039 <br /> Please print or pe.(Form dasgnedfor use <br /> DrIDNumbirte CAch) pmniter.) <br /> UNIFORM RAZARDWS 1'Ge"°r°rorlD Number CAD981375157 2�Pagetd 1.Fsier9enq'Respa^ea Prima lW^ tTnUdiq Number <br /> WASTEMANIFESTr 1 1-800-468-1760 00198298.4 _SKS <br /> 5R`fC1��.EllaaF'1tlGNSdreea GanaeMfsSteAddress(ddllleredNanmalingaddress) <br /> 800 W CHURCH ST STE B CA 45203 <br /> STOCKTON <br /> GenereMdaPMne: "'SYSTEMS, INC.209-629-5070 - <br /> U.s.IiDAID Nurber 05 <br /> TXR0000930 <br /> Number <br /> 7.Transporter 2 on pary Name <br /> U.8.EPADNwleber <br /> 8.Deaignreted 1: :-ity Name and FA-1 00-55 <br /> 1722 COOPER CREEK ROAD TX 76208 <br /> DENTON, TXD077603371 <br /> 940-483-5200 <br /> Faclll sPhanei <br /> 9a. gb.U.S.DOTDescdptlon(Indudng I mPer ShlPpirp Name,Hazard Gas;ID Number 10.CW wen 11.T001 - 17.UMI 13.WMaCodes <br /> HM and Peddng Gw(d amt) <br /> NO. Toe Oua^eh WUYab 0 <br /> g (HYDRAULIC OIL AND WATER) Oa <br /> w 2 <br /> uzl <br /> 3. <br /> a. <br /> 16.Spedal Handng s <br /> - nd Addhional In <br /> SK AUTH'D TO USE SUBSEQUENT CARRIERS: 41038, 87585, 81681, 82739, 85399 <br /> 15. GENERATOR'51OFFEROR'S CERTIFICATION: I Irereoy dadere that tiw COMWIS of Nie mnsignmeml are fogy a d sauretely dOuis W abave by the proper shpDh9 name,and ere tlaaal8ed,padraged, <br /> marked and IeheMNpMwdad.eM ere in Ore pmpercondiem far transport according to appllra,bb htematlarslend^atone gover,me^Ial mirut ema If aped animrnenlard I am the Primary <br /> Exporter,I wifly that Ne comers d N's consignment ou""to the terms d the a'laMee EPAAdm-�6o1`e)Co^e ma small Quantity generator)13 baa. <br /> I cortry Nat One MSM minimimam statement identified in 40 CFR 202.27(s)(if I am a large guantlry ay Year <br /> re <br /> Genaela'd0lleroys PdnfedlTyped Name - <br /> .� 10.Intematonal ip^nms ❑Import b U.S. ❑Export ham U.S. Port of erdryledl: <br /> (.. Date leaving U.S.: <br /> = Tmnaporler aignanum(for More mlYl: <br /> w 17.Tan Recelpt Of Mamdals. Month Day Yea <br /> eNre .s� <br /> y. Trane r 7 Pnimled?yped a <br /> N <br /> . MWN Day Year <br /> g Sgna ore <br /> 2 renporer2 pad ams - <br /> G 19,Dlsaepanm ❑FU RNed^n <br /> Indication ❑RaeIdU9 ❑Pemei ReJatim <br /> 15e.Disaepanpy peW ❑ OuantilY ❑Type <br /> Meefeal Rebrence NUMer: <br /> U.S.EPA ID Number <br /> 18b.Altemete Faddy(a Gawatw) <br /> U <br /> Fadlilys Phare: Month BY year <br /> W 18c. gnebaedAllemate FadYty(a Gener`W0 <br /> 19.Haraauhrawtreexnb(bowl,and recyrirg syereme) <br /> W aae <br /> t 2. <br /> O ' <br /> 20,Desgnated Fadity Owner Or OP~e CedMutlobdla<eipldheraNWe metsmils Wverm by Na nienhe exCtpt as aged In Item lfie Day Year <br /> neMre <br /> P n yped ame <br /> EP�1Forrn�70o-22(Rev.3-05} Ptaviousedio ns are obsolete. 4) DESIGNATED FACILtTYTO DESTINATION STATE(IF REQUIRED) <br /> 1 n1R f,RG ) 3� <br />