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BILL OF LADING/MANIFEST nipper's US EPA ID No.(If Applicable) Document No. p Paget <br /> of <br /> 3.Shipper's Name and Mailing Address SAN JOAQUIN REGIONAL TRANS <br /> 1533 E LINDSAY ST <br /> ATTN TRANSIT DISTRICT <br /> STOCKTON CA 95205 <br /> 4.Shipper's Phone( 209 )948-5566 <br /> 5.Transporter 1 Company Name 6. US EPA 10 Number A.Transporters Phone <br /> _ n rA00 66l <br /> 7.Transporter 2 Company Name e. US EPA ID Number B.Transporters Phone <br /> 9.Designated Facility Name and Site Address 050035 10. US EPA ID Number C.Facility's Phone <br /> AERC. COM, INC. <br /> 30677 HUNTWOOD AVE <br /> HAYWARD CA 94544 CAD982411993 510 429-1129 <br /> 11.Shipping Name and Description 12.Coni ners 13. 14. <br /> Total Unit <br /> HM :No. Type Quantity wwol <br /> a. UNI'VERS'AL WASTE LAMPS <br /> ( FLUORESCENT LAMPS ) CF P <br /> b. <br /> S <br /> H <br /> I c. <br /> P <br /> P <br /> E <br /> R d. <br /> 15.Special Handling Instruction and Additional Information <br /> HFST R/T#108635468 0000- 3711••6]. <br /> EMERGENCY RESP 800--468-1760( 24 HR ) . IF UNDELIVERABLE RETURN TO GENERATOR. <br /> SK CORP AUTHORIZED TO RETAIN LICENSED SUBSEQUENT CARRIERS AS NECESSARY. <br /> SKLIOT# A: 1.4815 B: C. : D: <br /> 16a.US DOT HAZARDOUS MATERIALS SHIPPER'S CERTIFICATION: 'Thad ie to camp me the above-named mateneie am property deal elemental packaged.marked and labeled am ere in pmper <br /> wndiepn fiat en odatbo deco di to mea Iimble dadmo Mme oe Mmem of Tmna anaron <br /> Printed/Typed Name Month Day Year <br /> ee <br /> 16b.NON-REGULATED SHIPPER'S CERTIFICATION: I cerlify the materials described above on this form are not subject Wederat regulations for Transportation or Disposal. <br /> Printed"yped Name t A r Month Day Year <br /> I y. t a 1 (".,; 2tile <br /> • T 17.Mniporter 1 Acknowledgq1tril Receipt of Materials <br /> R <br /> A Printed ed Name Signature./ --" -w` _ Monrh Day Year <br /> P .�...�....... <br /> O 18.Transporter 2 Acknowledgement of Receipt of Materials <br /> TPrinted/Typed Name Signature Month Day Year <br /> E <br /> R <br /> 1'9.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L 20.Facility Owner or Operator:Certification of receipt of materials covered by this form except as noted in Item 19. <br /> 1 <br /> T <br /> Y Printed/Typed Name Signature Month Day Year <br /> GENERATOR'S COPY FORM NO.90291(11/96) <br />