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T1111111111MI � <br /> SSL SK SHIP# • ° `"8 <br /> 3 00609955TSK ,3 <br /> print or W.(Forrn designed for use on elite(124tch)tpewdler.) F .OMB No. 9 <br /> HAZARDOUSUNIFORM 1. weraw 10 Number 2. 1 of 3,f 4.Man t T ki Number <br /> VVASTE MANIFEST 'y <br /> 57 SKS <br /> 5.Generators Name and McNingAddressp Ge s Sao (N Rerdnt ) <br /> �ii <br /> i in <br /> CA <br /> Generator's Phene: <br /> "TMYqWft SYSTEMS INCU.S EPA ID Number TXROO 081205 <br /> 7.T Aar 2Comliany Name U,S.EPA ID Number <br /> J) 12,24flul <br /> Dealgrrated Fed*Name and Site Address THERMO FLUIDS INC U.S.EPA ID Number <br /> 8. <br /> 4301 W JEFFERSON ST <br /> PHOENIX v AZ 85043 <br /> 8 —350-7565 AZR060603681 <br /> F Phone: <br /> 9a. 9b.U.S.DOT Description(Including Proper Shing Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> HM and Grorp(tany)) No. Type Qmtty WtN01. <br /> '- NON—RCRA HAZARDOUS WASTE SOLID DM P 223 <br /> (DRAINED/UNDRAINED USED bIL FILTERS) <br /> w 2_ <br /> 3. <br /> a. <br /> 14, f TSD:TPA SAL CSG: <br /> 24 HR EME Y1 0-4 —1760 (SK / TFI) <br /> AUTH AS M AGENI—EURIf <br /> 15. oENERATOR' 8 :I hey declare that the cheats odf constnmentam hAyaW accuridsly desatbodabove by the pmperwppbv name,and are classified,padca9ed, <br /> miulted and lebeMplacarded,and aro In all respects in proper cordtion for transport according to applicable and neftW govemmental regulaffons.t export shipment and I am the Primary <br /> Eqoftr.I that the contents of the convignmwent conform to the teres of the attached EPA Admowledgment of Consent. <br /> I certify that the waste minimization M 40 CFR 262.27(a)(if I am a largo quantity )or(b)(d i am a small qAr* )Is true. <br /> r s tray Yea <br /> >y I <br /> 16. ❑Import w U.S. ❑Export from U.S. of enty/41- <br /> Tmlspw (for ) U.S.. <br /> 17,Transpoder Adinowledilment of React of Materials <br /> T 1 MDay year <br /> T 2 ! Day Year <br /> �Ej18 Discrepancy IV <br /> 18a.Discrepancy m1caton Space ❑ Our,* ®Type ®Residue ❑Partial Rplection Full <br /> Number:I Me"Relater" <br /> 1ft Memate FsdGty(a ) U.S.EPA K)Number <br /> L3 <br /> wFaoatrps Phone: <br /> 18e.SigrwW_is of Altemete Facility(a Generator) Month Day Year <br /> 19.Hazardous Waste Report Management Met ad Com(i.e.,codes for hazardous waste treatment.disposal.and recydhV system) <br /> 1. <br /> 20 F of receV 16azardous materials covered by the manifest excAps Mad In <br /> 11orm787 7 /1 3eadons are <br /> obsolete. DESI TED FACILITY TO DESTINATION STATE(IF RE4u1 D) <br />