|
..• ., ....a ,�r,.ae rva. N4V,,6AW l6aPIM 9.30.99) Q�
<br />print lir Pa. Fah dasioaci!erase on dite ) Sao Initruc"On3 On ba f page 6.
<br />5 — O 1 Dapert+nant
<br />of Toxle SUhsIQPcq, p
<br />ror's US EPA tD
<br />UNIFC IRM' iE 0U5 1..Cr.nera Na.
<br />Sacramento, Ca}I is "•''
<br />%rn
<br />Monif.at DoeY
<br />WI STE FEST
<br />o. 2. Page 1
<br />Information In fhe shodad areas
<br />, mill" 1 (} 5 cj
<br />3,
<br />is no! required by Fedtpral iaw.
<br />Geteratoe. Namem4AllalkagAddl
<br />ofl
<br />4®® LEtr SAFETY-KLEEN SYSTEMS, ZNC A &ah Mavfrtt Docvmonl Numbar,
<br />'ACX DRIVE rryy.�`
<br />.9
<br />LUSTER TI NLDG 3
<br />J',L
<br />?rr
<br />.n�T 75024 /1 A
<br />>f10n1 l 1 X l 5 0 2 S
<br />N
<br />5• Transporter Compote ma'`k,^�
<br />y 6. US EPA t0 Nvmber
<br />^ ,
<br />C Sk" Trlamepart.r's "
<br />AF �, ° Y —
<br />® LEEN SYSTEMS. INC O 0 0 3
<br />y) 7.
<br />,1
<br />D, Trarteporp/.Ilion.,
<br />Tran+pprhr : COetp<iny Nam 8• US EPA iO Nanber
<br />C"
<br />E. sroto T t'anspetsr's RD,
<br />:,ctrP`
<br />�V
<br />Q
<br />9. Designated F, cRlly r" and Sib Addr.essperrel"s
<br />10. US EPA ID N.mber
<br />F. Tran
<br />`
<br />718501
<br />G
<br />rte?
<br />AFETY-,K r E INC.
<br />OS0 SAL [DA $LVDTEMS,
<br />C 0 3
<br />H. Patdil:;
<br />ftj 68
<br />1 t. US DOT Dasa Ipdon i1naludil Proper Shipping Fem., Hazard Class, end IDNumber)
<br />12, Containers
<br />Zp
<br />13 Toal .ni
<br />No T a Ouom WVYOI L Watiti•N pibali V ,''F•
<br />USED CLEANING COMPOUNDS, N, 0. I B. N.
<br />te
<br />LI UID I NOT USDOT OR LTSEPA REGULATE D)
<br />,C:440
<br />N
<br />M EPA/ c
<br />`®
<br />'E
<br />Slate
<br />A
<br />0A1
<br />0
<br />'State'
<br />d.
<br />V
<br />Styli
<br />'Z
<br />.' ?DrrkK1�AfQ�Nf�
<br />If,• �.,,• :, �i.•A 1
<br />'•IV >•f�,1A.
<br />K. Handling Cede For WWF tlatellAbove,
<br />W
<br />, ,�, •Iv�h• J r,,�'
<br />' • tip: L:
<br />, b.cc
<br />SPWIal Handlin'hNlru�ton. and Addition ! I
<br />4 nfehnallOr,
<br />4' x
<br />�
<br />uj
<br />MERGENCY RESP 800--468,1760 24 HR MFST
<br />). xF UNDELI
<br />R//T 103600954 7-185-01
<br />RAHLE RETURN TO GENERATOR,.
<br />'d
<br />q
<br />16, SNE Will 1
<br />M 5 ERTt�,ATfON: I ha dada n Iltat Ilia
<br />U
<br />morked, and lab rl.d, enf are Ful e C 51� Inscribed above b ,I J1 no name a
<br />oald are in an rapacrs in Proper eanditiott lar tronspori highway according b applicable inl.rrgfional and �ienol g 'a closeified, parJt.d,
<br />government togulallons. /
<br />vo"s'
<br />If I am o large q ,any1y geoerall I cartl(y that I kava a p ram in
<br />Practicable and r tat I . IalacNd the praaimblo meths aF um In
<br />dar rmined to be ocenoml
<br />and the eto men Int; 910 ra, a die volume and ioxiciyr of waste ganarorod ro the del I havetl
<br />if 1 tSta a small gaan4ty I have o geed 11 sent
<br />�A to me nimizeemay wasste
<br />9en.raror, made Faith .l
<br />available b me c x1 Ihat F sen afford.
<br />of I
<br />anst daFulu
<br />genneerro enland s�aloc�tolhe
<br />t
<br />oB m el
<br />ame is
<br />>-
<br />U
<br />Printed No
<br />Signature
<br />UA
<br />Month Day Year
<br />T
<br />0 , p
<br />17 to rw I Ask i I of Ilei t o�Ml
<br />Z
<br />N
<br />Printed liyped Name
<br />Sig.
<br />ka
<br />Moo16 Day Parr .
<br />•
<br />18. T rter Aoklull iriant of Racei 1 of Mater.
<br />C
<br />i 7
<br />fsrintad/Typal Nana
<br />tSignature
<br />Q
<br />month Day Year"
<br />CV3
<br />z -,A
<br />t9• Discrepancy lndiallon.Spoft
<br />c
<br />:
<br />,
<br />1
<br />L
<br />7
<br />Oe Per or ( Ce
<br />'Printed m.rti i tion of reel r of I al materials covered thiIlnifast ezc
<br />as noted rn I19.
<br />'•*j
<br />SlBnoh,re
<br />rte Dor ear
<br />DO NO BELOW THIS LINE, i-,
<br />DT3C AW— (1 99)
<br />�A;�� 22
<br />Bluer GENERATOR SENDS THIS COPY TO DISC WITHIN 30 DAYS,
<br />To; P•O Box 400, Sacramento, CA 95812.0400
<br />E0'd 62908b6 01 0898 SVS 602
<br />109812--AS dd 26:2-0 6661 b2 d9S
<br />
|