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08/07/2007 19:20 UBFNA STOCKTON 4 94683433 NO.734 P007 <br /> . sM FoMAPptoved.OMB No.2050-0039 <br /> Please PlAf r(Form designed for use an elite(12-pitch)typewr¢er.) <br /> Emeryency Response Prone 4.Manllen Tracidm Nunber <br /> UNIFORM RDOUS 1.�,.._rerorlD Number ChD115O92025 � � SKS <br /> WASTE (FEST 1 1-800-468-1750 <br /> S.Gerre2for9 Name and MailingAddress Ganemlws Sda Address(@ ddfererm San mating address) <br /> UNILEVER <br /> 1400 WAIERL00 ROAD ATTN Rai NOACK <br /> STOCKTON CA 95205 <br /> GansratWd Pmna: 209-466-958G <br /> u.s.EPA lDwumcer T$R000050930 <br /> s. I14C <br /> u.s P N�mbar <br /> 7.T r2com vv Nems - (/ <br /> r' ! c- Y r 1 U8.EPA ID Number <br /> a.Designated Fao'Idy Name end Ste Address SAFETY-KLEEN SYS' MS, INC. 0005_8 <br /> 1722, COOPER CREEV ROAD 1X 76208 <br /> MIME, TXD077603371 <br /> 940-483-5200 <br /> Faoftys Pnona: <br /> 9a. 9b.U.S.DOT Descriorlon(induct g Proper SKIxong Name,Hazard Close,ID Number, lo.No Canteinea. Type Quantity WL/Vol- <br /> Tog( 12.Unit 13.Waste Codes <br /> HM and PaCNnPGmuP(da")) <br /> 'A` 1 RQ VA TE BATTERIES, WET, PT4I.ED SdTTH <br /> P D00 In ttm <br /> o ALKALI <br /> 8 UN2795 PG SII (DO02)(ERG$154) <br /> z 2 <br /> w <br /> c� <br /> 3. <br /> d. <br /> iq Special Nandlmg lnsUucams and Additional lydormaaon Sri TRCK# 08641499 0001921719 <br /> SK AUTV TO US& SUBSE UFNT C 5: 40343, 41038,81681, 62739,86256 <br /> 15. GENERATOR'SfOFFEROR'S CERTIFlCATIDN: Iherebydeclare that'd�'c"amis of ma conaiWmant are Poly and acGualay descrM above by the propershil,099 name,end ale 01SM16 d;(adaged. <br /> malKed en0 ybeleNpleCdrded,and&e N all respects in proper wn[19n` r'JPnaW a000dirrg to appkabls ma maWnsl and rational goverunenal regulabom,If export shipmeAtard I am b6 PMwY <br /> ed <br /> Expoft,l cehdymt the wntat vl UM wrrsgnmerd conform to inetenzie Ulheeabaldred E�Miygenersba)orb del am ee 9mal querdlty generator ra hue. <br /> Icer*that the waaro mmimmiian statement Identified in 40 CFR J2.21(a)(fJ� wile9 �S� ) ()C � Month Day Year <br /> Generalors/OR ra PrirdeNlyped Na t <br /> r Al <br /> rya <br /> .� 16.IntemaWne GMpments ❑Import b U.S. ❑I✓gert frmn U.S. Port Of leertdyle.S. <br /> Dale leaving U.S.; <br /> Tmnapoder signature(for exports 0*Y <br /> K 17.TronspcOo AdmOvd8d9MOM of Receiptot Matan916 SlgnaNraMonth Day Year <br /> Tran PrinladRyped Name -/s V U'� <br /> O /a LA <br /> y S� , MmBr Day Year <br /> y7d. Transpo 2 fmledRYPed Name <br /> F <br /> 18. iscreperrcy <br /> las.DWepancy adicettW SPace ❑Tyya ❑Reddue ❑Partial RajeotiUl ❑FWI Rejedbn <br /> ❑ Quentty <br /> Ma.kvltzaference Nun r. <br /> U.S.EPAID Nurturer <br /> 5 18b,Mlemate Facility(a Gwrerstu) <br /> v <br /> u FadWs Phone: MUM Day Year <br /> W 1&,SynatureofAltemate Fadlty(or Geror91o) I <br /> Q <br /> y 19.Ha?ardals Weste RePud MarreAemer,t Mand Godes Pa,Cod"lit hazardous waeta tr?trrent disposal.and reyding syalens) { <br /> 3. < <br /> 2 f <br /> 20.M noted Fxrdity ONoeorOperet, ritficatian of recdplarnazerdoua materiels u+eed by vie maN tWe�• astgI am 18 1 Month Illy Year <br /> Pnntgtlrryped�Na ne S 1 <br /> a <br /> DESIGNATED 101LrryTo GENERATOt <br /> FP Faro (Rev. Prevwus 863are obsNete. <br /> t 1ru'1C1g044 2l <br />