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BILL OF LADING/MANIFE T I.Shippers US EPA ID No.(If Applicable) 2.F <br /> 1J C <br /> 3.Shipper's Name and Maiiling Address - RIG !' NIMAL NUTRITION <br /> 4, 44 Elk- DORADO ST <br /> 5 OCKTON <br /> 4.Shipper's Phone vi <br /> .9 -)j-,34- 4 39 <br /> 5.Transporter 1 Company Nam 6. US EPA ID Number A.Transporter's Phone <br /> 71-7 71 <br /> T KV <br /> 7.Transporter 2 Company Name 8. US EPA ID Nurnbei B.Transporter's Phone <br /> 9.Designated Facility Name and Site Addre;S 7221 10. US EPA ID Number C.Facility's Phone <br /> _.,r_iF'ETY-K; T'�;TE MSii <br /> "_t- �.i-Fi: INC. <br /> 6000 88TH I.;T <br /> SACRAMENTO "5828 CA00000845' <br /> 12.Containers 13 14. <br /> 11.Shipping Name and Description Total Unit <br /> F-H—M-] No. Type Quantity Wt/Vol <br /> a. �411NE_D U ED 01L FILTERS <br /> b. <br /> S <br /> H <br /> I c, <br /> P <br /> p <br /> E <br /> R <br /> d. <br /> 15.Special Handling Instruction and Additior al Information <br /> , K SHIP# 210143910078 3387201 <br /> 24 HR EMENGENCY #1-600--468-1,760 (SAFETY-KLEEN CONTRACT #94138) <br /> SK AUTHORIZED 'TO RETAIN LICENSED SUBSEQUENT CARRIERS AS NECESSARY <br /> DOT/PRFL. A. 14476/1501.67 S. C. D. <br /> A) NONE B) C) ' D) <br /> I i *This is to certify that the above-named materials are properly classified,described,packaged.marked and labeled and are in proper <br /> 16a.US DOT HAZARDOUS MATERIALS SHIPPER'S CERTIFICATION, condition for trans ort h J to the applicable regulations of the Department of Transportation. <br /> Printed/Typed Name I I Month I Day I Year <br /> 16b,NOWREGULATED SHIPPER'S CERT11FICATION: I certify the materials described above on this form are not subject to federal regulations for Transportation or Disposal. <br /> P t d[Typed Name Day Yea <br /> M`(I Z,It I <br /> T 17�.Tr/ansporter 1 Acknowledgerrient of Re Materials <br /> R <br /> A P,ncl/Typ�d N)5 L) Signatul Month Day Year <br /> N <br /> s 6 <br /> P <br /> 0 18.Transporter 2 Acknowledgerdent of Recelpt of Materials <br /> R I <br /> T Printed/Typed Name I Signature Month Day Year <br /> E <br /> R <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L 20.Facility Owner or Operator:Certification o�receipt of materials covered by this form except as noted in Item 19. <br /> T <br /> y Printed/Typed Name Signature Month Day Year <br /> ORIGINAL-RETURN TO GENERATOR FORM NO.01-90291 (11/09) <br />