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a UNIVERSAL WASTE BILL OF LADINC
<br /> Generator Name and Mailing Address Location Address(if different) No. 58739
<br /> PACIFIC Doc No.01062132
<br /> 2300 F_ 9:IGHT NI E ROAD SO No. 208817
<br /> VOCKTON,CA 95210
<br /> Emergency Contact
<br /> Phone No. PO No. 1-800-688-4005
<br /> Designated Facility,as checked below.
<br /> []Onyx Special Services,Inc. ❑ nyx Special Services,Inc. nyx Special Services,Inc []Onyx Special Services,Inc ❑Onyx Special Services,Inc.
<br /> 1275 Mineral Springs Drive 220 Perimeter Drive 711'TTT'''5752 West Jefferson Street 218 Canton Street 342 Marpan Lane
<br /> Port Washington,WI 53074 olumbus,OH 43228 Phoenix,AZ 85043 Stoughton,MA 02072 Tallahassee,FL 32305
<br /> (262)243-8900 614)276-3000 (602)233-2955 (781)341-6080 (B50)878-2259
<br /> WID988566543 HR000011007 AZ0000337360 MA5000004713 FL0000207449
<br /> Container Total Quantity
<br /> Profile# Count Type Waste Common Name DOT Description Cnt or Wt Discrepancy
<br /> Me ury Containing Articles RQ Mercury contained in manufactured articles,8,UN2809,PG F11,ERG#172
<br /> Mericury RQ Mercury,8,UN2809,PG III,ERG#172
<br /> Mer�cury Batteries Environmentally Hazardous Substance,solid,n.o.s.,9,NA3077,PGIII,ERG#171
<br /> Lea Acid Batteries-Sealed Batteries,wet,nons illable,electric storage,8,UN2800 PGIII,ERG#154
<br /> Lea Acid Batteries Batteries,wet,filled with acid,B UN2794,PGIII,ERG#154
<br /> Lith m Batteries Lithium Battery,9,UN3090,PGII,ERG#138
<br /> NiC d Batteries-Wet Batteries,wet filled with alkali,8 UN2795,PGIII,ERG#154
<br /> NiC d Batteries-Dry Batteries,dry
<br /> All ine Batteries Batteries,dry
<br /> Mixild Batteries Batteries,dry
<br /> Flu escent Lamps 4'and under Non-DOT Regulated(per 49 CFR 173.164(e))
<br /> Fluo escent Lamps V and over Non-DOT Regulated r 49 CFR 173.164(e))
<br /> Circ lar/U-tube Lams Non-DOT Regulated(per 49 CFR 173.164 e
<br /> :. i t �7C Com act Fluorescent Non-DOT Regulated(per 49 CFR 173.164(e))
<br /> Shat ershield/Shielded Non-DOT Regulated(per 49 CFR 173.164(e))
<br /> HID trips Non-DOT Regulated(per 49 CFR 173.164(e))
<br /> Merlry Vapor/UV Lams Non-DOT Regulated(per 49 CFR 173.164(e))
<br /> Inca descent Lams Non-DOT Regulated(per 49 CFR 173.164 e
<br /> Brok n Lams Non-DOT Regulated(per 49 CFR 173.164(e))
<br /> Othe Lam (Specify) Non-DOT Regulated(per 49 CFR 173.164(e))
<br /> Non CB Light Ballasts Non-DOT Regulated Ballasts for Recycling
<br /> GeneratodShippers Certi
<br /> fication: This is to certify that above named materials are properly classified.described,packaged,marked and labeled and are in proper condition for transportation according
<br /> to the applicable reg ations of the Department of Transportation.All containers of waste are fully described above and are presumed to be full,unless the Generator
<br /> Us s provided a detai d,ver�able breakdown of the wastes being pickup of delivered.Actual Quantities will be determined upon receipt at the Designated Facility.
<br /> �S nal Dale
<br /> TransponertName_ VIRUNMEN LSEFdVIL,i=SL.L.0 Transporter 2 Name:
<br /> t#p0-36tF'�Ofiri
<br /> Phone Number Phone Number:
<br /> to
<br /> Signature Date Signature Date
<br /> Received,subject to the classifications and regulationj in effect on the date of the issue of this Bill of Lading,the property described above is in apparent good order,except as noted.
<br /> Per 40 CFR 273.18(-4),40 CFR 273.38(d),and 40 CF 264.12(b)the Designated Facility agrees to receive shipments of Universal Waste from the Generator.
<br /> Date
<br /> 1_9:MF0ATAD
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