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SSL SK SHIP# 227324188 U���O 1111111 III IIIIII'IIIII'I11llll�nllll <br /> O O 67756666 K6 <br /> Please print or type. Form Approved,OMB No.2UWAD39 <br /> UNIFORM HAZARDOUS 1.GeramlmlDNumber TXR00O081205 2 '"'a 3. g880 gr76O 4.MmRM Tri Number <br /> WASTE MANIFEST 006715868 SKS <br /> s_%%'bV-ITEMSt INC. GeneraWsSBeAtl�esslgd6emdtlapmxlYogadYpssl INC. <br /> PC BOX 555 55fO1F50�SALl IIDDA BLVD <br /> SfiLIDR CB 95368 <br /> 209-545-1011 SRLIDR CR 95368 <br /> Canerzmrs Pnora. <br /> 6T3AFE19dp ttR SYSTEMS INC U.S.EPA ID Number TXRO0O0812O5 <br /> 7.Tmrgioner2Canpany14 U.S.EIRP,IO Harmer <br /> B.Deagnand Faaey Name and SmAnd. — U3.EPAIDNlaom- <br /> 6880 SMITH�F(VE. <br /> NEWARK a CR 94560 <br /> 510-795-4400 v CRD98O887418 <br /> Fail' sPnoia: <br /> 9a <br /> 9b.US DOTOevap4on(mturing ProperSimran,Nam Hazard Class,ID Number, ID.Cmawnem 11.Tdal 12.Unit 13.Wwb Catlr <br /> rvM aq Poddg Gmup lnanYll No. Type Quark Wi <br /> 1. — <br /> c (USED DIL) 00 <br /> z <br /> w <br /> 3. <br /> 14, <br /> 14.Spedd Handin,ln¢Wdms and A rdaral lMmmaGOn <br /> 24H EMER13ENCY#8O0-466-1760-CH/SK/TFI-Contract retained by generator confers agency authori y <br /> on initial transporter to add or substitute additional transporters on generator's behalf. <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION' Iherebydediare Nal Nemnhnbuf Nis consignmad are fully and mocamplydeadmed above by the p'ppaz NNpY5 name,and eradearred.packaged. <br /> named and IabdMlplaaded,and are In all rasps to in maerwndiWnforbareponaaortliiy Ioaporrelme intemaramaland national g mantra it mi,ubEw IIaWM akgrenleM I ea},69Priiery <br /> Exporter, ceniFy Nal Ne ranlanhd Nis wnsignmedoanmrm IONelemradgaanamm EPAAdrowkdgmenldCornad <br /> I ceNrylMl Newasle minimisation imhmenl kentl(redNb CFR2822)Ia1101 amalerge quarNty gerdalml arlbl lNl oma quantiy generala)h Na. <br /> Gendmprangman a Print Sigremm MmN Dal Ypr <br /> L1812- <br /> 16. <br /> .Intimaemal Shipments ❑Impttlm Us. ❑Edroommus. PrndermyleA <br /> Tormarrlersignamre fm exporh ody) Datelaavirgus: <br /> K 17.Tmra Ar mdetlgmenldR 010Maler <br /> CTranawar l Pram,7Typed Name Smark. retire Day Y. <br /> glZ27l9 <br /> 2 TrampMer 2 PnnWffypdName Sgndure MwM 0, Year <br /> t1a.Discrepanq <br /> too.D&retenrymdintim 5paoa ❑ ouanEly ❑Type ❑Resitlua ❑PaMN Ri ama ❑Fuu Repdim <br /> Warmer Rakranse Number <br /> 10h.A0dnah Facillry lm Gerereb.'1 U.S,EPA ID Number <br /> U <br /> LL <br /> PMne <br /> y3 <br /> lil.e . <br /> Q� &.Sgnalure pfANemele FaciNylar Geremtm) MpnN Day Year <br /> Z <br /> a—i 19.Hazadws Wash RepM Menegammr McNoticpdesga„(pees brbauNouawesktreeNceM,d'cpwal.aM lerytivgryaiem) <br /> C 1. 2. 3, 4, <br /> 2p Orsgrsled Fadliry aDpnamr:fnNfiatim Nrece'gldM1axaNww mekrah 1 wueredb�Vam"Gooexmptes Metl In Ilam l0a PonIeWTypM aero SGraNremN Day <br /> EP�..�vltgeJ iF�a� if) PraviouseQb are obsolete. OE DFACILITY TO EPA's e- ANIFES 5 T M <br />