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Excluded,Recyclable Material 1.Bill of lading 0 2.Document Number 3.Date <br /> Manifest b4(t?2 (P USR 2018-000,693 -18 <br /> 4.Generator's Name and Mailing Address S.Generator's Phone <br /> Universal Service Recycling,Inc.3200 S.El Dorado St.Stockton,CA 95206 209-9449555 <br /> 6.Transporter-1 Company Name 7.Transporter's Phone <br /> Universal Servite-Recycling,Inc.3200 S.EI Dorado St.Stockton,CA 95206 209-9449555 <br /> 8.Transporter 2 Company Name 9.Transporter's Phone <br /> 10,U <br /> DOT Proper Shipping Name 11. Containers 12.Total quantity 13.Unit,Wt. Recycled Pursuant <br /> i.Rrh$1►��- <br /> No. Tyne Volume to HSC 25143.2 <br /> A<�<iti•�i nu ES-Under HSC 25143.2 <br /> Metal Shredder,Aggregate-Excluded Recyclable Material 001 DT T meeting requirements for <br /> s SSection 25413.9 <br /> B. <br /> C. + :m <br /> D. <br /> 14.RecyciirfkWability Name and Mailing Address 15.Facility Phone <br /> UnhierSS)Service Recycling Nevada I.I.C.5855 Sheep Dr.Carson City,NV 89701 209-9449555 <br /> 16.Additional Description for Material listed Above <br /> Mixture of materials containing plastics and recoverable metal;coarse and fine-grained materials including recyclable metals,recyclable plastics,and <br /> non-recyclable materials including foam rubber,insulation materials and entrained soil and grit.Shipped aggregate is an excluded recyclable material <br /> undRli,th'R•provisions of subdivision(d)of Section 25143.2. <br /> 17.S ecial Handling Instructions <br /> No�oi lal handling required;inquiries contact: Universal Service Recycling Project-Excluded Recyclable Material <br /> 24 Hr.209-751-9946 for Environmental Health and Safety Manager <br /> 18.Generators Certification:l hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> packed,marked,labeled and are in all respects in proper condition for transport according to applicable domestic regulations. <br /> l also recognize that in spite of product name or appearance,these commodities are being recycled and are either non-hazardous or conditionally exempt from <br /> hazaidaus waste regulations.As the generator,Ram making a good faith effort to minimize my waste and am taking advantage of new technology and existing DTSC <br /> regulations to comply with SB 14 by selecting the-best methods that are available tome and that are economically practical. <br /> Generator or Authorized Representative/Print Name SignatuMonth Day Year <br /> 0.v (t re 3 -19_11 <br /> 19.Transporter 1 Aaknowledgement of Receipt of Materials <br /> Print/.Type.Name Sig ur Month Day Year <br /> 20. 1Sansporter 2 Acknowledgement of Receipt of Ma s <br /> Prir 11'ype Name iffrint/Type Name Month Day Year <br /> tern Hca <br /> 21.,P�lsgep%nrN Inc(ication Section <br /> 4 <br /> 22.Facility Operator:Certification of Receipt of Excluded Recyclable Materials by this Document except as otherwise noted on line 21 <br /> Print/Type Name Signatuo Month Day Year <br /> i <br />