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SSL SK SHIP# �� 7 IIINIIII IIIIII���IIIIIII�II�II III <br /> 006l41 � 153K3 <br /> Please print or . Form deslgtted for use on elite (12prtch) typewrite . G Form Approved, OMB No, 20%0039 <br /> UNIFORM HAZARDOUS , Generator 1D Number CALM0416532 2. rol 3. 0 ` 0063 91415 SKS <br /> WASTE MANIFEST5. Generators Name and Mating Address ener"s Slte Address (if different than maIN address) <br /> Can J Franke Electric Inc <br /> 330 N. Grant St <br /> STOCKTON CA 95205-2633 <br /> Generators Phone: 209-462-0717 <br /> a, Traoeoalar Opmyppy,NaNa SYSTEMS INC U.S. EPA ID Number TXR600081205 <br /> 7. Transporter 2 CCompatntr Naam�Va U.S. EPA ID Number <br /> CLEAN HARBORS ENVIRONMENTAL SVC INC. MAD039322250 <br /> dDeslgnatedFaciityNam and Silo Address CLEAN HARBORS SAN JOSE U.S. EPAIDNumber <br /> 1021 BERRYESSA ROAD <br /> Fedtys Phone: SAN JOSE , CA 95133 <br /> 408-441 -0962 CAD059494310 <br /> ga. 9b. U.S. DOT Description (ndu ft Proper ShWN Name, Hazard Class, 10 Number, 10. Containers it. Tota 12. Unit 13. Waste Codes <br /> HM and Paddy Group (I any)) No. Type Quantity W11M. <br /> X 1 • NA3077 HAZARDOUS WASTE, SOLID, N. O. S. DMP P D00 352 <br /> o , ( CHRbMIUM ) , 91 PS III /� � � <br /> `Ser <br /> W X 2. NA30821 HAZARDOUS WASTE LIQUID, ! DM P D00 D006 D007 <br /> N. O. S. , (CHROMIUM, LEADS , 9, PG' 111 t PA <br /> 'DOOE D009 223 <br /> ( , PEffl <br /> C <br /> 14, Spacial Handling Instimtons and Additional Information TSD : SJ 77807052 C082732 C`SG : '.. <br /> 1 ) ERS# 171 . 2 ) ERG#171 • 1 uq <br /> 24H EMERGENCY#800--498- 1760—CH/SK/TFI —Contract retained by gene for con rs agencon initial transporter to add or substitute ws � &% y author ' y <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby dealers that the contents oftNswnsipwi are 6Aly and accurately described above by the proper shipping name, and are dassifed, packaged, <br /> marked and IabeleNplacaded, and &-a bbi all respects in properoondi8ar for transport according to applicable intenk'tlOrd and national governmental regulations, It export shipment and I am the Primary '... <br /> Exporter, I car* that On contents of this const runent conform to Ste terms of the attached EPAAclurml dgmentof Gcnsea <br /> I <br /> I oe* that the waste mi kniza6on statement identifed in 40 CFR 262.27(&) (d I am a large quantity generator) or (b) ( f 1 an a small quantity gerieraw) is true. <br /> Gena s Printed/Typed }� Signature Month Day Year <br /> 130 vs <br /> --h 18. IntematIonal Shh{nants <br /> F ❑ import to U.S. ❑ Evodfrom U.S. Pal ofer"lexit <br /> z Transporter signature (Por exports only): Date leaving U.S.: <br /> V. TrenspoderA4nowledgment of Reoapt of Materials <br /> 0 T r 1 PdnteNTyp�lame S gnaNra -- Day <br /> % `erg <br /> a d (�9ro <br /> ?d Tra mspo(ter 2 P ted(Typed lure r - <br /> 18. Discrepancy <br /> 183. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Parfial Re)ecdon ❑ Full Rejeclitn ' <br /> Man f�stReference Number. <br /> 18b. Aliemate Facfty (a Generator) U.S. EPA ID Number <br /> � I <br /> U <br /> +� FaciWs Phone: m <br /> C3 180. Signature ofAttemate Fedity (m Generator) Mordh Day Year <br /> Q <br /> Z <br /> 19. Hazardous Waste Report Management Method Codes (w., codes for hazardous waste Meorrnent, disposal, and recycling systems) <br /> 0 1 . 2. 3. 4. <br /> - i <br /> 20. Desi noted Fadior tor: C gxxrtlon of roansnaeA WYA by the manifest except note l int <br /> Print Name tu MOO Day ear <br /> D <br /> ilion <br /> EPA �olmSZ0032 (Rgv13 �S�Prgvjiws �are� As D& c FA ITYT ESTI A ON STATE IF REQUIRED) <br /> 1 X676597 07 3y� ) 7 480ts <br /> VZ <br />