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I���III�Il�-f I�III-Bill of Ladin <br /> 9 t+fufnbcl 1 1,1 I i 1r}.114 I? �[ 3149546-001 <br /> 1131051 a p + A 1lr/+ LU` Date of Pickup <br /> 1 DILL O LADING Pane 1 of 4 24 18 <br /> �r�t�f's 11fe arts!M.11ltrlq�t�[ffUSS frnrllH'I,ry Pl,nnr 1 (877)577-24659 <br /> Ger1t!rnlnr's Silt Addrrs�il+Iif frTrr r+nl Ill:�+ti rn:i hfu1;nirlrrr;} <br /> dicks Sporting GocidsI)at176 <br /> 5354 Patlflc Ave-nue Dicke Slrorllny Gomr1R7 Of 170 <br /> Stockle,n,CA 9526I(2DA)992.5745 5354 Priellle Avot,un <br /> 516cklon,CA 95207 2099425745 <br /> ilA4 ITS 001 Dfunplion 11mimi,11til hole,`tlHl i ul P4.111111.I I i ,uuntirJCnnllaln,'rs Tntnl Unit SSiln Waslrrnd'•5 <br /> Nn- f poisue Ounnllly VJT Nol, <br /> snrrws caar+aN moil",2 2 <br /> 1. <br /> x <br /> I tIr 7 P <br /> 2. <br /> x <br /> x 3• ' <br /> x <br /> a. <br /> A4k1 tmrM1 I ofp malmn•Lab C h <br /> {1l GICKSCfS 4 -ERCO20J DI['K$Ep2-p;{- �gppp tyl0lf nE ICC7]CAplR1pCE5 <br /> Conlract/PO No. — — Special Inslnxllons/Reasons for May — .— --_— — <br /> j� Over <br /> ' packs <br /> y;l(C' Slarl Time <br /> Arrival at Cu tomer <br /> Departed CuslomCr <br /> Detay Time — — <br /> GtNERATOR MEFICATION <br /> -1 he ruby declare that She contents of this mnsignrnerlt am fully and mwrale•ly described above by proper shipping name and cImmif1C[r,pxkaged•marked and <br /> labehed/plar-wded,and are in all mspecls in proper condition fa transport a«ordlnq to app4cWnbcfnaonaland n n:>f g vernn5ent 9 requlaharn,•I also CenSlfy that all <br /> /hmes.lizled atgve are iron and cm-rect. <br /> Prim pa1e y <br /> Tractor I Trailer Y Box Spatted 0 4-Picked lJp leer <br /> Transporter 11 <br /> NAME STERICYCLE SPECIALTY WASTE SOLUTIONSINC Phone_- <br /> EPA ID NO. MNSON110924 <br /> t?rtril Name Darryl.lahnsDrl - Date 4 24 18 <br /> Transporter 12 <br /> 1dAME_� _ �+t•►' l' •�' Phone <br /> EPA ID NO. <br /> Print Name Date /190 <br /> TSDF Arrival Time Reason for Delay <br /> TSDF Departure Time <br /> Delay Time _- -- — -- <br /> finish Time •_ <br /> Contacl Broker <br /> t I4S, /Trearnent/StoragODisposal FacilJty LPA IdenfJRcallen Code No. NVDQBOB95330_ , a-- this ge.-c-7tC^ iS thFppi11g,_ <br /> Cosigned To:21st Century Environmental Management of Neveds LLC <br /> 2095 Newlands Or.East, <br /> Fernley NV 89408 (775)575-7760 <br /> This is to Certify the acceptanceof this waste for treatment storage dispo <br /> Prinl Name t-ar skDate <br /> Scanned with CamScan <br />