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ORDER 0 417287 <br /> NON-HAZARDOUS I.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Waste Trac 'ng u bar <br /> WASTE MANIFEST d 0 0 0 2 8 9 <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> SILGAN CONTAINER CORP. <br /> 1815 NAVY DRIVE <br /> STOCKTON, CA 95206 <br /> Generator's Phone: <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> UNIVAR USA INC. <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> MXI MAUMEE EXPRESS INC N J D 9 8 6 6 0 7 3 8 0 ` <br /> 8.Designated Facility Name and Site Address U.S.EPA ID Number <br /> VEOLIA ES TECH SOLUTIONS „ <br /> 5736 WEST JEFFERSON ST. j <br /> PHOENIX, AZ 85041 <br /> A Z 0 . 0 0 0 3 3 7 3 6 0 <br /> Facili 's Phone: - <br /> 9a. 10.Containers 11.Total 12.Unit a. <br /> 9b.U.S.DOT Description <br /> HM No. Type Quantity Wt.Nol. <br /> yY <br /> cr 1. UNIVERSAL WASTE (ALKALINE DRY CELL BATTERIES) <br /> Q <br /> cc <br /> Lu <br /> w 2. UNIVERSAL WASTE — LAMPS <br /> (SPENT FLUORESCENT LIGHT TUBES) C F <br /> 14 <br /> 3. <br /> 4. <br /> x. <br /> t c! <br /> 13. Special Handling Instructions and Additional Information <br /> 1. 284633 2. 522724 <br /> PLACARDS PROVIDED BY CARRIER/SHIPPER YES/NO DRIVER SIGNATURE <br /> **** ER CALLER MUST IDENTIFY UNIVAR USA AS REGISTRANT **** <br /> x�t <br /> 14.GENERATOR'SIOFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, e <br /> ..'" marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental r ulations. <br /> Generator's/Offeror's Printed/Typed Name Signature Month Day Year <br /> p�NE.z. l 17 a� <br /> 15.International hipments <br /> F ❑Import to U.S. ❑Export from U. . Port of entry/exit: <br /> y <br /> Transporter Signature for exports only): Date leaving U.S.: v' <br /> U.1 <br /> 16.Transporter Acknowledgment of Receipt of Materials <br /> F— Trans p rte(1 Nam Prin(ed/Typed Signature Month Day Year <br /> Oa — 6 2 0 <br /> )1 z Transporter 2 Printed/Typed Name Signature Month Day Year "r <br /> °N a • <br /> cc <br /> 17.Discrepancy <br /> 17a.Discrepancy Indication Space g' <br /> ❑Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection 5 <br /> � 4s <br /> Manifest Reference Number: <br /> >_ 17b.Alternate Facility(or Generator) U.S.EPA ID Number 7 <br /> av V <br /> n LL Facility's Phone: <br /> w 17c.Signature of Alternate Facility(or Generator) Month Day Year <br /> F- <br /> 1 z j <br /> Ft. <br /> N <br /> 18.Designated Facility Owner or Operator:Certification of receipt of materials covered by the manifest except as noted in Item 17a <br /> Printed/ryped Name Signature Month Day Year ,w <br /> DESIGNATED FACIL.1TYTO GENE!R.AJOR <br />