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7-18S�-Q1 , <br /> Please:pdtlt or (Fofjff for use on elite(12 pili►) tf}r `i: & l orm roved.OMB Nb.20 0039 <br /> UNIFORM HAZARDOUS. <br /> 9.Generator ID Number I2. **g-1-�.31. <br /> Response Phone 4.Manifest Teack Nine <br /> WASTE MANIFEST CAD982497828 <br /> 5%etators Nara and Maft Address Generators'S Address(d different darn mailtrD address}. t <br /> CAL TRANS. -DIVISION 10 Ile CAL TRANS DIST 10 <br /> 1603 8- ST EQUIP DIU. <br /> STOCKON•. CA -95206 24153 S CORRAL HOLLOW <br /> c,amrators Pbww :249-27+-693 TRACY- CA 9;1376 <br /> 8:Transi 1 Compo Name: U.S.EPA ID Number <br /> SAF TY-K(LT N SY81EI18, INC. dA. TXROOOQ84930 <br /> 5 . <br /> 7.Transpdrter 2 Company Name U.S.EPA ID Numbel, , <br /> 8.Designated Facility Name and Site Addr®ss $AR TY-°Kt, EN �3Y87 11S. INC. 000 760 <br /> u.S.EPA ID number <br /> 6000 88TH STREET <br /> SACRAMENTO985 <br /> K t� 20 <br /> .. _ "�AOOOQQ84�17 .. <br /> Faulil es(Mone: <br /> • 9b:U.S.DOT Description(including Proper.81104 Name,Hazard Class,ID Number. 10.Conlafners 11.Total - :.12.unit 1$,VAMe Codes <br /> HMP mg P(del' Pio. Type Quantity WWoI. <br /> 'No -RCRA HAZARDOUS WASTE, LIQUIK� DK1 ti 13¢ <br /> (AQUEOUS .FARTS Ld ER SOLUTION) <br /> Uj <br /> 2. <br /> t;a <br /> . 3 <br /> 14;specie Handling instructlons and Additional Intorma9on SR TRCK1108780421 0034896330 0000370033 0?,V-. <br /> ED ZWIE",As assfiax <br /> 15:,GEN RATOWSWFEROR Si GERVICATION:f hemby declare that the is of We maul are ttdfy and above by the proper shipping name,and are <br /> marked and Pe aml.are In adrespea'm proper condition for transport aocorr#ng to and governmental regulationsd export sMpit f*WI 0*Pty <br /> l:zpbrter,`I oar8fy thatowaWnS of tips 6"sovneat rwrdom to the loans of lino e6dwed EFAAciftwledlimeni'of Consent <br /> I car*that tfre waste mintaketion statement wandW In 40 CFR 262.27(s)(N I am a large quank generator}.*@)(dl ama smallis lure. <br /> Garreralof s yped l .: rn,e Day Yeer <br /> Irrynott to U.S. D Bgxwt from U.&. Pat Of entryle* <br /> .Transporter signature(for.exparts only}:_ Dale lemrbg U.S.:, <br /> 17!T Ac&noH9edgmenlofRow4koftlt*Ws <br /> T 1 Name re: ter Day Yaer. <br /> r <br /> Transpolar Pn tore, : orntlt Day Year' <br /> : <br /> 18.discrepancy . <br /> 1.8a.Dtsaeparwy Indication Space E Qum ❑nType ❑Residu® �Partial l��ton, �FWI Rej®dbn <br /> Manifest Reference Number: <br /> 18b.ABmnate Fadlhy(or Gensra�} U.S.EPA ID Niunber <br /> Fad litys Phone: <br /> M Oay Year' <br /> 18c.Sigrnatuie of Allamate FaaFly,(or enoato} • <br /> N ,19.Hazardous Waste Report Management Mediod Codes(i.e.,codes for hazardous waste treatment, and recydhg systems) <br /> t:.. ¢( �t1 2. <br /> P.,Designated Fadidy Owner or.Operator Certification of receipt of hazardous materials owmed by fare manifest except rged In Item 18a <br /> f t7h you <br /> EPA •22 ev.3 0 Previou n s are obsolete.w:': DE GNAT 11:1 ENERATOR STATE(IF REbt I Dj <br /> 1 0014941 2) - r..�' <br /> * .t t <br />