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v <br /> _—P.—Waste Tracking Number <br /> NON-HAZARDOUS 1.Generator ID Number 2.Page t of 3.Emergency Response Phone <br /> WASTE MANIFEST <br /> 5.Generator's Name and Mailing Address Generators Site Address(If different than mailing address) <br /> STOCKTON UNIFIED SCHOOL DIST. <br /> 1932 N. EL PINAL DR. <br /> STOCKTON,CA 95205 <br /> Generator's Phone: �� - --, <br /> 6.Transporter 1 Company ame U.S.EPA ID Number <br /> AEFRC.Com Inc. CAD982411993 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> 8.Designated Facility Name and Site Address U.S.EPA ID Number <br /> AERC.Cot11,lnc. <br /> `' <br /> 57''HUNTdVOOFJ AVE. <br /> 3.0 <br /> I-CA.•Y• YARD,CA 94544 <br /> Facili s Phone: 10-429-1129 <br /> 9.Waste Shipping Name and Description 10.Containers 11.Total 12.Unit <br /> No. Type Quantity Wt.Nol. <br /> ac 1 used/sped lamps for rer;VC-.ling-no va!Ue-urilvers3l waste p <br /> Dot-Non-Requiated <br /> W ! ovo <br /> W 2' <br /> fi£ed/£pent ii?E rch`£(tialia£t)for recvcllnq no value-universal waste or" Iol— <br /> P <br /> 00' <br /> 3. <br /> usedtspenl potasslurn hydroxi?.le <br /> solld,i sun:K1Ei:=Pi=lll(ERr-M154iunlve;£al waste <br /> 4. <br /> usedtspent tiatterle£ 1Vet,filled with acld,3,un2794,PGlll(El?C� <br /> 154)urlNersal vvasre <br /> 13. Special Handling Instructions and Additional Information <br /> t'gx-f-5 <br /> pot <br /> 14.GENERATOR'S CERTIFICATION:.I certify the materials described above on this manifest are not subject to fede egulations for reporting proper disposal of Hazardous Waste. <br /> Generator's/Offeroes Pdnted/ryped Name Signa Month Day Year <br /> 15.International ShipmentsEl <br /> Import to U.S. Export from U.S. Port of entry/exit: <br /> Transporter Signature for exports only): Date leaving U.S.: <br /> cc16.Transporter Acknowledgment of Recent of Materials <br /> Transporter i Printed(T Name Signature Month Day Year <br /> �ca �k � �� zl <br /> ZTransporter 2 Printed/Typed Name Signature Month Day Year <br /> 17.Discrepancy <br /> 17a.Discrepancy Indication Space <br /> ❑Quantity ❑Type 1-1 Residue ❑Partial Rejection El Full Rejection <br /> Manifest Reference Number: <br /> ?- 17b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> V <br /> W Facility's Phone: <br /> 17c.Signature of Alternate Facility(or Generator) Month Day Year <br /> Z <br /> tS <br /> N <br /> W <br /> 18.Designated Facility Owner or Operator.Certificaffon of receipt of materials covered by the manifest except as noted kr Item 17a <br /> P ame Mgnth Day Year <br /> 29c <br /> 169-BLC-0 6 10498(Rev.8106) DESIGNATED FACILITY TO GENERATOR <br />