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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number <br /> UNIFORM HAZARDOUS CADv 616�75t)N.3 ,,''TT,^� ' 4379A <br /> WASTE MANIFEST a_ ^+ 0 t„I'_� v„v <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> SAN J0011IN REGIONAL TRANS <br /> 153; E LINDSAY ST ATTN TRANSIT D1 STRI <br /> .'TOCKTON CA 95205 <br /> Generators Phone: 209-9 4 8-5 515 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> SAFETY-KLEEN >YSTEMS, INC TXROOf%J`.'% <br />