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TEXAS NATURAL RESOURCE <br />C,Q RVATION COMMISSION 7-18'1,, <br />P.O. Box 13087 = <br />'�. <br />Austin, Texas 78711-3087 <br />Please print or type. (Form Eesigned for use on elite (12 -pitch) typewnier.) <br />Foran approved, ONG No. 2050-6039, <br />TN&U�l( ./ 1 c n n n o t n n n nn I <br />n o c nt Ink -TSS 1 n tl O,Q M1 4'6i6sporVErJ"�'ir7�8�2 f t�r /.�<'/ yj 6 <br />UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifest <br />2. Page i Information In the shaded areas <br />WASTE MANIFEST I - <br />of I is not required by Federal law. <br />3. Generators Name and Mailing Address ADVANCED INTERCONNECT <br />P.O. 952 <br />A. State anifestDocument pNumber <br />S 00942039 <br />555 CARNEGIE STREET <br />B. State Generator's ID <br />MANTECA CA 95336 <br />a. Generator's Phone 209 24-6555 <br />D0006 <br />5. Transporter 1 Company Name 6. US EPA ID Number <br />C. State Transporters ID <br />D. Transporter's Phone <br />7. Transporter 2 Company Name 8. US EPA ID Number <br />E. State Transporters ID <br />l w �C' /�.).(p 3 .Z co <br />F. Transporters Phone 9<015 <br />9. Designated Facility Name and Site Address00061 8 10. US EPA ID Number <br />G. State Facility ID <br />SAFETY-KLEEN SYSTEMS, INC. <br />65124 <br />1722 COOPER CREEK ROAD <br />H. Facility's Phone <br />DENTON. TX 76208 <br />11K <br />11. US DOT Description (including Proper Shipping Name, Hazard Class, ID <br />12. Containers13. <br />TotQuantity <br />14. <br />I_ <br />HM <br />Number and Packing Group) <br />No. Type <br />Wnit <br />olof <br />Waste No. <br />a. RQ WASTE ALCOHOLS, N.O.S. <br />Zc o0 <br />X <br />(ALIPHATIC ALCOHOLS) <br />a4t <br />P <br />OUTS203H <br />3 UN1987 PG II (D001)(ERG#127) <br />�y <br />G <br />E <br />N <br />E <br />b. WASTE PAINT 3 UN1263 PG II (ERG#127) <br />3 <br />GC(� <br />/ <br />X <br />DM <br />P <br />OUTS209H <br />A <br />T <br />0 <br />R <br />c. <br />I RG14 N(Of Fr`t(f *mnn(v <br />Z cto[r vsea-e-�sesvrtTfSy-r'� <br />i <br />1 <br />d. U,)A.5'7f 0tl ;1A!/) J�(3jCJ-'l3Eil.y N'!ry(r6:^-E <br />(A;0 % 9c12rl /ZEgvL;irEd> <br />Yn <br />OL)1-53/o/ <br />J.AB/ ioamdprial hi Sr tM� LOf�TAD20 3H IB) DOO1 I�-}ivi z- K. Handlin Codes for Wastes Listed Above <br />vL q� {{ l4( <br />7b) AIOAJ E <br />15.3pP,cial }Japoljrtg lnslruclion%Bfld Ad i�joglal Vf�r�n6tMrSr <br />(14 HR). IF UNDELIVERABLE RETURN TO GENERATOR. <br />YS: CCK7ILL llCii ((ORRIIPVV((;; iiAUITf CH: �'YD <br />TO USE SUBSEQUENT CARRIERS: 81300,40355,41015,40$,82,84815 <br />SKDOT# A: 1963 B: 23547 C: 1444'Sti: /6Syg(� <br />16. GENERATOR'S CERTIFICATION: I hereby declare that the contents or this consignment are fully and accurately described above by the proper shipping name and are <br />classified, packed, marked, and labelled/placarded. and are in all respects in proper condition for transport by highway according to applicable international and national <br />government regulations, including applicable state regulations, <br />If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br />economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and <br />future threat to human health and the environment: OR, if I am a small quantity generator, I have Made a good faith effort to minimize my waste generation and select <br />the best waste management method that is available to me and that I can afford. / <br />l <br />Printed/Typed Name <br />Signature Month Day Year <br />.2 1�t <br />T <br />17. T nsporter 1 Acknowledgement of Receipt of Materials Date <br />A <br />'Printed/ T dName <br />�l/�F S <br />S' ature -- Month Day Year <br />5 <br />1� <br />1 P7 10. <br />o <br />porter 2 Acknowl!@Mel of Receipt of Materials <br />Date <br />R <br />PriritNrTyped NameSi <br />natur Month Day Year <br />E <br />t-<4 r, <br />�--� t. it n <br />19. Discrepancy Indication Space k <br />F <br />A <br />c <br />I <br />I <br />20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br />y <br />Date <br />Prin�adrll ped Namef f <br />Si ) Month Da Year IG <br />TN&U�l( ./ 1 c n n n o t n n n nn I <br />n o c nt Ink -TSS 1 n tl O,Q M1 4'6i6sporVErJ"�'ir7�8�2 f t�r /.�<'/ yj 6 <br />