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r• <br /> 714A.. <br /> pie ale �a e. am designed for use on elite 12-pitch)typewriler.) Form Approved.OMB No 2050.0039` <br /> 1.Generator ID Number 2.Pa i of 3 m se h .Manifest Number <br /> UNIFORM HAZAROQUS CALr74G 105725 g� �—�`�YR -•��`�Q 4Manift Tracking <br /> WASTE MANIFEST 00433672 <br /> 5 F <br /> 51 ratoes Name and Mailing Address Generators Site Address(if different than mailing addressl <br /> LE <br /> _CARGILL ANIMAL NUTRITION <br /> 4344 S EL DORADO PO BOX 36Y <br /> STaCKTON CA 95201 <br /> s GeneietoesPhone: 209"9� '4b32 <br /> t 9%M MTTV SYSTEMS, INC, U.S.EPA ID Number TXR000050930 <br /> Tlari}port¢r 2.C�gmpacry IVpme .. . U.S.EPA ID Number <br /> 8.QWWRN ed7ityNeme�ertdShe Addrew OFETY—KLEEySYSTEMS, INC. i u I)Number <br /> 000 SETH S _ EET. <br /> A4RAMEMTQ • ... <br /> s2s <br /> ;4 <br /> 9L 94- •49#3 CA0000084517 <br /> Facild Is Phone: <br /> 9a. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, A 10.Contesters 11.Total 12.Unk 13,Waste Codes <br /> HM and Padnng Group(lf any)) No. 7 Quantity W[Ad. <br /> 1.''NONY CRA: D . iiA8T6, l.I4UIp . -. OM 0 134 ' <br /> (AQU'EQUS PARTS:i1�1 ER SOLUTION) / <br /> 14 pecW Haroinguntrwlialsand Into Gott 3K 8HI1'iF2t�l$4284f►3 51974$�,7i9 371 '54 x^01040 GSCi 4' <br /> EMER0EMCM -8.00,4 sI b4 (S TY-i(LEEN -". 941 e) <br /> K UTH R D ' EYAI ICENSEO SU Q ENT CARRIER AS NECESSARY <br /> .15. QdN.ERAT0R'S10FfEROR'S C Rt f ICATION: hereby dedare that the contents of this consigriment are fully and accurately described above by the proper shipping name,and are classified,packaged, - <br /> « <br /> marked and labeledfplacarded,+nd @re m altrespts rn eloper condtion for Transport accordtrtg to applicable inlemaG¢rtal and hafional;governmental regulations.It export shipment and I am the Primary <br /> Exporter,I certify that.the yontants of the consign ent conform to the terms of the attached EPAAck w4edgment of Consehl. <br /> I.cerli{y that the waste minkrwzation statement iderltified in 40 CFR 262.27(a)(if I am alarge quantity generator)or(b)(11 lyna sm quantity generator)is true. <br /> �tler-e r'sesry Name igna y <br /> W & ' <br /> antemational Shipments <br /> port to U ❑ Port of errUylexit:, <br /> '?fang ers' nature for&x rtao Damieavl U.S.: <br /> K 17.Tr_a f edgment of Recelp(�I Materials <br /> rarisfAar 1 P yped a ear <br /> 16.Risaepanry . .' <br /> 18e.pigcmpancy Ir6catlort space M( <br /> "liity ❑Type ❑fte�idue ❑Partial Rejection ❑Full Rejectbn ;,k <br /> Mani St Reference S <br /> tSb Nfemate Facility{or Generator) i r' U.S.EPA ID Number <br /> Facai!s Phone: 't <br /> QIlk.S' tune otAtterttate f arlty(os Genetalot)- :a Month Day' Year <br /> - 3t1:Harardotra Wgs1e Rtpprt (is:,codes.lor hazardous wade 08UPWA.distAs@l and:rscyclin9 systems) <br /> -:a <br /> rw6slgnaf6bQ0.or Qperata:,Certl6caWn f receipt of hazardous s covered by N9 manifest except ted in Item 18a <br /> r S' lure Math Day Yea► <br /> 1 <br /> f ; f <br /> s are bsolete. 0I <br /> NATED FACILITY T0 GENERATOR STATE(IF REQUIRED) <br /> , <br /> .,vvw••.�•..r : ice+-w,.,.. w.. ... .. - - - . <br />