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09/24/2010 14:44 9404835257 S PAGE 02/02 <br /> 7-185-01 � <br /> 1 <br /> Please print or".(Form deal road for use on elle 12 itch ler.) Fane roved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS r•0°nereror D Number Z.Pegs 1 of 3.Emergency Reopen"Phone d,Menl rel res Ing u <br /> WASTE MANIFEST cAL00o310240 _ —404-1700 001509533 SKS <br /> S.Generemre Nedheene MAAing,onreco Geramloea Site Address(id erentma,malllag address) <br /> MCLANE FOODS <br /> 800 EAST PESCADERO DR <br /> TRACY CA 95304 <br /> Genernmrnph.ne 209-221-7514 <br /> 9,Tien rtrc 1 Co Nr.ny U.S.EPA ID Number <br /> SAFETY-KL�E�I SYSTEMS, INC. TKR000050930 <br /> 1.Trarmcfawr 2 Convey Nmno U.S.EPA ID Nwdw <br /> Elie OKD � �p <br /> e.DodgmeedFoolery Noma and Ste Address SAFETY-KLEEN SYSTEMS INC. 000518 U.S.EPA ID Number <br /> 1722 COOPER CREEK ROAD <br /> DENTON, TX 76208 <br /> Each aPholm; 940-483-5200 TXD077603371 <br /> ga, Ab.U.S.DOT DewWn anouding Proper Shipping Name,Fayard Dleae,ID Number, la,Conminars 11.Tbtaf 12,Unll <br /> HM and Pecking Group(if any)) 13.WsNn Codes <br /> No. Ty 0uenllty W1Nol, <br /> a WN RCRA HAZARDOUS WASTE LIQUIDS Li �F «co p 221 S <br /> (USED OIL) <br /> w <br /> z 2. <br /> 3. <br /> a. <br /> .Sp9uelHenaingmslmalpnsaneAdenlonallMomemn SKTR 109905373 0003274117 <br /> SK AUTH'D -NT <br /> 15. CENERATOR'SIOFPEROR9CE9FICATION: l homey declare that the mntenmof then eonxlArmmnlafofvlly snd ecsurereydesertbad ebova gy lno pnoper shipping name,axle Are.CaaslAEd,packaged, <br /> marked and Iobol.N iftewdad,snd Any In an respects In propor eondgPoe for transport acmrding 10 applicable Inlamalloneland national Pmernm enrol mgu191109.If export shipment and I am fns Primary <br /> Expert,ar.I cenle,!hat the centonls of this condgnmem mm"to the lomm or the Attached EPAAcknowlndamant of Conoenl. <br /> I canny that the wnote ml nerlsation Statement iderdNed In dA CFR 282.27(.)(II I am a large qunnt'y germme r)or(b)(ifI am a..I[quantity ger"10r)IS true. <br /> Ilomror$K1 fadfi)pad Nemp / sl naIu Mdnth Day Year <br /> C—h Iq I&S <br /> 16.Inlernanonm Shlpmobta _ <br /> ❑Import to us. ❑Expgn from U.S. Pon of emyla.S. <br /> Transporter xlgnnmm(for expode arty): tlhl0 leaving U.S.: <br /> ca 17.TrenapartxAcknmiedgmem of Ronlpt of Materials <br /> . Tmnm Ma 1 Pdnl9d7Typed o Signal <br /> 4NC7 901 L Yam <br /> N MOB <br /> Ina sponer2Pflnmtlflypotl Sion atW <br /> k/ /y Manlh DAY Year <br /> (i, <br /> 1e Discrepancy <br /> IIs.Diadreparzy Indkason$pan ❑ Type ❑ResidueII��II <br /> F1Partial Rnlndion LI FWI Ro)ecllon <br /> 181A.Atemste Facility(or Gerr ct" Monlfeet Rnfnmloo Number, <br /> J <br /> U.S.EPA ID Number <br /> V <br /> LL FecWlye Frons <br /> u,Slgrewrc mAl{gmele Facility(a GenerAloO Momh Day year <br /> 2 <br /> 19.Flraa'd.us Weare Repan Mon.gomem Margaret Cede.(I..,mduc ler ma nao,ug weerd tr.armant,al iposte,ab rxyeling Fontana) <br /> 4. <br /> 20.0901gnaled Fsdiy ON or 000"'Y.CodlBn Boa o(mcWPI dhemedcus malenols mvaad by the manlfsst except as nded M tom 1Be <br /> jll Pml°dffypsd Name slgmeuro MomA �o }p <br /> 1or <br /> &)0187644nIR�ey.3.06) PreNoue3t)lonsRmdhsolele. 4) DESIGNATED FACILITYTO DESTINATION STATE(IF REQUIRED) <br /> 1)200187559/1140291467 <br />