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7-185-01. <br /> Please print or type.(Form deal ed for use on e8ter 12 ch +tef.) Form ved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1..Gen eratm ID Number2.Page 1 3 Phoae Manifest Trac ng Num <br /> WASTfr'MANIFEST CAD98 2497 8 28 000727978 Wo <br /> 6.Generatces Name and Maifing Address Gi Silemms of MW int maling address) <br /> CAL TRANS DIVISION. 10 ° CAL TRANS DIST- 10 <br /> 16015 H ST E UIPp DIV. <br /> STOCKTON CA 95206 2155 S CORRAL HOLLOW <br /> Gener"s <br /> 6.Tranporl r 1 Company Name — U.S.EPA ID Number <br /> SAFETY—KLEEN SYSTEMS, INC. TXR000050930 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> B.Designated Facility Name and Sita Address U.S.EPA ID Number <br /> SAFETY—KLEEN SYSTEMS, INC. 000760 <br /> 6000 88TH STRE9T. <br /> SACRAMENTO CA 95828 <br /> FeWsMvw 926-346-4913 CAOOQ0084517 <br /> ga. 9b.U.S.Off DesorlpUon(Including Proper Shipping Name,Hazard Class,ID Num* 1 D.Contakers 11.Total 12:Unit 13.Waste Codes <br /> HM and Paddng Group( enY)).. No. Type Quantity wivol. <br /> 'RON-RCRA .IiAZARDOUS -WASTE LI UID DM 0 134 <br /> (AQUEOUS PARTS WASHER SOLUTI�N) <br /> 2 . <br /> 3. <br /> 4• <br /> 14. Handling instrua-rid MIEVIXWon SK TRCK#109146954 0035669578 0000370035 0752 25 <br /> SK AUTHORI <br /> 16. 4ENtcRATOR'SfOFFEROR'S GERTIFtCATfQN:I tt�ahy declare#ret the contents is txire aro and aoaaatslp above the proper Hanna,and ala classified, <br /> marked and labelecilpikercled.and am In aN In propo for kansPort accorft bappicew Intemationsiand national governamw regulation M expert shipment and I am the Pdmary. <br /> Exporter,I cai*.that&a contents of thisconsignment cadam le Me terms of do abdW EPAAdmowledgment of Consent. _ <br /> I Ifuat t.wade rntnl E aeon statement identified In 40 CFR 252.27(a)(I I am a i or(D) f f apt a small quantity generator)Is Nae. <br /> Genera dlOi'eme tedff ame Moo <br /> ," <br /> 16.International W4 to U.S. ❑F.wfrom U.S. Port of <br /> Tfaospater (farexpotaoNy): Date baft U.S.: <br /> IBS17,TrartsportclAdmowl ofReoeiptof Materials d= <br /> T 1 P+In Itch Day .Year <br /> 2 a PAOnBtif Year <br /> 18. <br /> 18a.blscrepancy Irdcathn Space ❑ Quantity K gType ❑Resided ❑Partial Rejection, ❑Fui R**n <br /> Manifest Reference Nuri : <br /> 18b.Alternate Fadtity(or Geheretor) y U.S.EPA ID Number <br /> �j <br /> Faciit/sPhone: _• ._,.,.,tix DayYear, <br /> 18c.Signature of Facility(or Generator) <br /> t2 19.Hazardous Waste Report Management Method Codes(1.e.,codes for hazardous waste 7eameeK dlsposai,and recydNg systems) <br /> 1. H141 2. 3. 4. <br /> 20.designated Fadlhy or Operator.Certification f receipt of hazardous materials covered by the manifest except as Wed In Item 18a <br /> ear <br /> EPA:Form 87 -22( ev 3:N Pr® s dbm are obsolete. DESIGNATED AC GENERATOR STATE(IF REQUIRED) <br /> 1)0014941 2) 3) 4) <br />