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AUG-19-2010 14:30 FROM:MONKEY'S AUTO & RU I 2092394618 TO:4683433 P.9/10 <br /> -f lga6e riot or (Form dafdgned fry use on elite 12-pitch)typewriter) Form Approved.CMB No.20•.70-0039 <br /> UNIFORM HAZARDOUS 1,GeNraler ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifem Tracking umber <br /> WASTE MANIFEST CAL00031,ry9.37 �. , <br /> _R �� ; . �� SKS <br /> 5.Generator's Name and Mailing Address Ganeroter's Wo Address(If different Omn malling addmuz) <br /> i�C:;4toi:LY ;itl I�1i° <br /> 48 ./: AIRPORT WAY AVE <br /> MANT' (,A CA 95.337 <br /> Generalora Phond, .Q_2 5' t <br /> 8.Transporter 1 Company Number <br /> SAFETY -1<i F EN SYSTEMS, IN(' <br /> TXROW)t, -t}', .a0 <br /> 7.Transporter 2 CampartyNama _._ U,S.EPA ID Number <br /> '. -r <br /> 8.Doaignatod Facility Name and 3ito Address � .•eF, c r;? ,^•.- ", <br /> SAFETY-KLEEN S1'-TEMS, 311U.S.EPA ID Number <br /> 1722 COOPER CRM ROAD <br /> DENTUN; TX 71020A <br /> Fadil 'sPhone: 940 4 a 3 `1h00 1 T X FD <br /> 9a 9b.U.S.DOT DerAption(including Proper Shipping Name,Hazard Class,ID Number, 10.Conlalne+e 11.71otal 12 Unit <br /> HM and PSCKing Group(dant)) No. Type Quantity MAti. 13.Waste Codes <br /> a X bAZARDOUS WASTE LIQUID, N 0. PM P DOGE D007 C :08 <br /> ( irZMIZATI ON BOTTOM )9 1]/131012 P':' :II <br /> 1':04#2'f 1 D006. DU08 j ! /` 2w2 OUTS <br /> cy <br /> 3. <br /> A. <br /> 14.Special Handling Instrijetlews and AdMoriflnforrnaikin <br /> SK 7q.MJod5a'Mb&° 000306.651 r <br /> r <br /> r <br /> 7 "N Q R F' <br /> 5. GENERATOR'S10FFEROR 9 CERTIPlGATION: hereby deGare mat me contents of la cons ment are tully and accurately daecrlbed above"'by' <br /> the proper shipping name,and are classified,packaged, <br /> marked and Iebeleftiaeardad,and are In oil resiwte in proper condition for transpotfaccordine to applicable International and national gpvemmental regulations,If nxpud shipment aria I am me Primary <br /> Exporter,I carfify that the contents of this consignment oonform to the terns of the gb0ted EPA Ack mledgrwt of Cor W. <br /> I certify that the waste minimization statement identified in ao CFR 282,27(a)(il I ah a large quantity genet=)or(b)(if I am a small quonflty generator)la we, <br /> Generator Iferors Prinfewlyped Name gnakre n Month Day Year <br /> i <br /> . f IV <br /> ctefnaHarmr 5nIPMOA13 ❑Import to Us� ❑Expor'from U.S. Port of envexiC' <br /> Transporter signature(for exports only)- Data leaving U-3- <br /> 17.Traruparter Acknowledgment of RwAlpt of Maardals <br /> Transports;1 Printed ed NameSlgneturo 7 Month flay Year <br /> 0 C/ <br /> spode. antedams 9lgrfsure Mrmrh Day Year <br /> 18,Disnpancy <br /> 1&i Discrepancy Indleatlnn Space ❑ Quanul <br /> Y ❑7Ype ❑Partial RaJaction ❑Fru Rejection <br /> ManlRsr Reference Number. <br /> I8b.Alternate Facfllty(or Generator) // U.S.EPA ID Nurnber <br /> J <br /> V <br /> � Fecility'a Phone: <br /> in 18c.Signature Adornate Fa4ly(or Genv for) 7 / <br /> Month Day Veit <br /> 18.Hazardous Wmrto Report Management Method Codes lie-,codes for nazardoua waste treatment,disposal,and recyog cows) <br /> G 1' { Z' 3. <br /> yT4. <br /> i I <br /> r <br /> 20.D oted facinty owlW or Operator:Caus rtlBatbn of receipt d Hazardomaterials covered by the mahifest.e <M as nded,ln ram I as <br /> n o yy , ria , i <br /> i Man 7ar t <br /> t t <br /> EPA F rm 700- a t5) Pre ious editlo are obsolete. D9-SIGNA7ED FAPERATOP <br />