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SSL Sk SHIP4 223708264 1111111111111111111111111111111111111 <br /> 0 0 6 3 7 1 2 9 1 S K 3 <br /> Please print or type.(Form designed for use ori elite(12-pitch)typewriter.) Farm Approved.OMB Nc 2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 1""'y <br /> of 3 Emy R s se n 4.Manifest Tracking Number <br /> WASTE MANIFEST cAL0000s204o1 1006371291 SKS <br /> 5.Generators Name and Mailing Address Gereratui Site Address(if different than mailing address) <br /> Stockton Steel Stock-ton Steel <br /> PO SOX 6429 3003 E Hammer Lit <br /> STOCKTON CA 952208--0000 <br /> Generator's Phone: 209-956-4751 STOCKTON CA 95212-2801 <br /> 6 T§AVeKoRL?ftV SYSTEMS INC U.S.EPA ID Number TXR000081205 <br /> 7.Transporter 2 Company Name U.S. PA @ Nu bei ��D <br /> 8.Designated Facility Name and Site Address SAFETY—KLEEN SYSTEMS, INC. U.S.EPA 0Number <br /> 6000 88TH STREET <br /> SACRAMENTO CA 95828 <br /> 916-386-4913 GA0000084517 <br /> Facility's Phone: <br /> ga 9b.U.S.D07 Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit <br /> HM and Packing Group(if any)) <br /> 3-Waste Codes <br /> No. Type Quantity Wt.Nol. <br /> 1 NDN—RCRA HAZARDOUS WASTE, LIQUID � G 134 <br /> Elf (AQUEOUS PARTS MASHER SOLUTION) <br /> a <br /> w <br /> Z <br /> LU <br /> 3 <br /> 4 <br /> 14.Special Handling Instructions and Additional Information TSD: SCA 75071670 ST26434tt�] 201745 CSG:23 <br /> L <br /> 24 HR EMERGENCY # 800-468-1760(SAFETY—KLEEN) l 6 <br /> AUTH A "AGENT—FOR" BY GEN TO RETAIN LICENSED SUB CARRIERS OS NECESSARY <br /> 15. GENERATOR'SfOFFEROR'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,packai <br /> marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable intemational 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 EPA Acknowledgment of Consent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.271(if I am a large quantity generator)or(b)(if li am a sgall quantity generator)is true. <br /> Genera or'slOff a PrintedlTyped Name Signature Month Day Year <br /> ,)< S^►� 1 <br /> J 16.InternationalShipments <br /> Z ❑Import to U.S. ❑Export from U.S. ort of errtrylexit: <br /> Transporter signature(for exports only): Date leaving U.S.: <br /> W 17.Transporter Acknowledgment of Receipt of Materials <br /> OTra rt( I PrintedCfYP e Signature / Month Day Yela7 <br /> LAA <br /> Q Transpo r 2 Pr n ame(aJ Signature Month Day Year <br /> t— <br /> V 1 <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication SpaceLl <br /> Quantity ❑Type ❑Residue ❑ adial Rejection ❑Full Rcp:cf r <br /> Manifest Reference Number <br /> 18b.Altemale Facility(or Generator) <br /> U.S.EPA ID Number <br /> _i <br /> V <br /> I Facilitys Phone: <br /> W 180.Signature of Alternate Facility(or Gereralor) Month Day Year <br /> Q <br /> z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 1 H141 2. 3. a <br /> 20.Designated Facility Owneror Operator:Certifcadan of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> PrintedlTyped Name ���� Signature Month Da Year <br /> ti _ Y <br /> ti V i /_7 <br /> EPA Form 8744-22(Rev. -05 Previous editions are obsolete. DESIGNAT D FACILITYTO DES NAT N STATE(IF REQUIRED) <br /> 1)14941/156023 <br />