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7142 <br /> Please print or type,(Form designed for use on elite 12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIF=P RQOUS 1.Generat.rIDNumbw k,-AL0001.0_1? ._, 2.Paggglof 3E �tgppt�s_ePbprya} 4.—Manifest Tracking Number c�[c <br /> r1 �r f. 1—tSU! i'S L 4r 00245425 V�\V <br /> WASTE MANIFEST <br /> 5.Generator's Name and Matting Address Generators Site Address(if different than mailing address) <br /> CARGILL ANI94L NUTRITION <br /> 4344 S EL DORADO PO BOX 369 <br /> STOCKTON C.F, 9520: <br /> Generators Phone: 209-982 463,- <br /> SYSTEMS' <br /> b3?_SYSTEMS' NC U.S.EPA ID Number TXR000050930 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> 8.Designated Facility Name and Site Address $ FETY-KLEEN SYSTEMS, INC. U:r9;Et?A,ZDNumber <br /> 6300 BIRTH STREET <br /> SACRAMENTO; CA 95828 <br /> 916 -38b-4913 i:fa0000084547 <br /> .r <br /> Facili s Phone: <br /> 93. 911 U.S.DOT Description(including Proper Shi "ng Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> KM and Packing Group(if any)) No. Type Quantity Wt.Nol. <br /> 1 NON—RCRA HAZARDOUS UASTE, LIOUID t?I1 5 134 <br /> o (AQUEOUS PARTS WASH�R SOLUTION)LLI <br /> Z 2. <br /> C7 <br /> 3, <br /> 4. Ad <br /> 14.Special Handling Instructions and Additional Information SK SHIP#2400943200 50976636 371751 . 20102.4 C56: 24 <br /> 4. <br /> a <br /> 24 HR EMERGENCY T#1—li0pp—�468-17bt7 (S FETY—KLEEN = 94138) <br /> SK AUTHORIZED TO RETAIN LICENSED SUBSEQUENT CARRIERS AS NECESSARY <br /> 15. GEN ERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> marked and labeledlplacarded,and are in all resp%ft in proper condition for transport according to applicable inlbmational and national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached F-PAAckrawledgment of Consent. <br /> car*that the waste minimization statement idead in 40 CFR 262.27(a)(I I am a large quantity generator)or(b)(ifl am a small quantity generator)is true. <br /> 21 <br /> Generators/Offemrs Prkiledi7yped Name Signature Month /Day Year <br /> J 16.International Shipments -rl <br /> rt to U. ❑Export from U.S. Port of entry x4: <br /> Transporter slgna exports only): Date lea' U.S.: ti <br /> W17.Transporter mens of Receipt of M rials <br /> ii Transporter 1 dnted/Typed Name nature Month D y Year <br /> O <br /> QTransportef 2 Pn a S' Month Day Year <br /> 18.Disr#epancy _ . <br /> 18e.Discrepancy Indication Space tj c[U64 ❑Type ❑Residue ❑Partial Rejection ❑F01 Rejection <br /> Manifest Reference Number: <br /> 18b.Alternate Facility(Or Generator) U.S.EPA fO Number <br /> V <br /> LL Fadity's Phone: Month Day Year <br /> w 1&-Signature ofAllemate Facility(or Generator) <br /> . Z <br /> - 19.Hazardous Waste.R M r,e,codes for. ttrdous waste treatment,disposal,ar d Ins tams) <br /> apart ane�ertlafltldet!g9._ ..( . tri posy recycling ys <br /> >, 4. <br /> 20.Designated:Facility Owner or Open .Oerfification t receipt of hazardous materials covered by the manifest excep in Item 18a <br /> PpAsdaped Name i ignature Month Day Y r <br /> t.1 <br /> �- J /G l <br /> El)FiV4i/1gUj; •) Previous edlionsare obsolete. ESIGNAT FACiLITYTO GENERATOR STATE(IF REQUIRED) <br />