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SSL 9( SNIP# 226994$04 1111111111101111#111 <br /> 006657111SKS <br /> Form Approved.OMB No,2050-0039 <br /> Please pent or type. A RW Traddng kw bar <br /> UNIFORM HA2FRDOUS 1 u�aa0f ID"umber CaL00035863�;t <br /> 3. "-'ate' e 006687118 SKS <br /> WASTE MANIFEST <br /> 5.Generales Name and&�ifir�Address GaerasXs Sea Addrea&{R diaemrd tlsen maiing addressS <br /> D & D Lift lnc. <br /> 3820 Rhonda Way CA 95384-1608 <br /> TRACY <br /> Fa.D,,,�pE�r <br /> r5 Phone: 1209-229-7448 <br /> U.S.EPA 16 Numhm TXReSM1205 <br /> �aL+ SY5tEh4S INCCor: NameUS.EPAIDNumb®'9QBNrFS ENVIRONMENTAL SVC INC. MAD039322250 <br /> acWNems and Site Address CLEAN }{ARBORS SRN JOSE u.a EPAO Numbs <br /> 1021 BEARYESSA ROAD <br /> 488-441-0952 CA 95133 <br /> SAN JOSE + CAAe59494310 <br /> F"itys Phune. <br /> 9a 9bU.S.DOT Desaimn(vddrg Proper SFWnA Name.Hazard Class.lD Numrdea, '0.C,atakmrs 11 Trial 12.Ung 13.Waste Cade& <br /> H1A end Packrg Gwp(darty)) <br /> No. Ty;o 0uartAy MMJVtl, <br /> TIMM <br /> D + � <br /> r <br /> NON-RCRR HAZARDOUS WASTE, SOLID DM Sb P 223 <br /> (OIL FI47ER5) <br /> 3, <br /> 9. <br /> 14.Soedal Handlx+g eesrsriars and Add al W—d- TSD:SJ 78339574 D C56: <br /> Qj`31L-•11 �'� p <br /> 24H EmERGENCY08M-468-1750-CH/SK/TFI-Contract retain. by geti�e r confers a en ail y <br /> on initial trans orter to add or substitute additional ens nrters an enera o s behalf. <br /> i5 GEMFAATOR'SOFER01t'S CFR WATIOM:I hereby dedere tlrx 6sa OarlanU d ri®mssgnrnent we tidy eM emaatey deeal6etl abrwe W the P adpde9 rema,ar+tl are riattited,padraged. <br /> m ked ane mheedrplamrdea.end sm n AN reVem A WOW mvwn lartranapataaarpng beep""Inlemm w am nacnnsi gmawnwiel mgcd sya I mgxid slipmedand 1 am tha pninary <br /> Eapwleq I=*"g,sa'+tana d lbs corbig lent mnierm to the Erma of the slmcied EPA Admarakdgmen at Carlaew. <br /> caddy to L*waste merrn®tior'-ammirnere idmAed m 40 CFR 262 271x)if I am agar*pumralarl or tbl(1R OM a aind )e true. <br /> (.srreramrwoferors psrAe6TyWd Hlk IT <br /> Day Year <br /> ifi.I SMpmerts ❑Impon to U.5. ❑ Seca U.S. Pal A en vot <br /> Tmnwom,sigratme(im expoA&drK Dare having U.S. <br /> 17.Tran&parer ACkrma4dg+Qd d Reodpt aY ki�lsriala <br /> MG* Day Yasr <br /> Transporter 7 PrcrmdlTyp�N7rn�� N V–A L� 11J�_ } �� 'a ��.[� I f ft 4D 1,3 <br /> Tm�Lsporter ala �`� � � Lbo Day Year <br /> 16.Deaepa'rcy <br /> +aallsawwm y wtaiw.space ❑Ow,* ❑Type ❑Rastlue LPartial Re)ed'an ❑Fua Agecem <br /> Nanr'eS:Reference Namher. <br /> 18b.AMrrn;a Fwtty M aewa*rj U.S.EPA ID NOW <br /> 7 <br /> Fdmty's Phone <br /> 1 lure ul Adamata Faddy lar nem�r! Uomh Day Yaw <br /> 19 Haxare ous Walk Report Managemam Mednd Cads li e._mdes for haesrdo+a+waste veabnaM dspasal.and recytirrg 6yetemsl <br /> I� 2' 3. 4 <br /> ` 20,D0sprlaozd t:ad"ry a Dperakr GmdMalion al mrzyt materials DY �✓�eaceptad m <br /> ,��, y <br /> EPAF�rm970a2--2``Rev.12.77 Prep spy DESIG ED FA I4 A'Sa-MANIFESTSYSTEM <br /> s-.e00 g fi.8.� 't 0 Y I MY/T`ti777 <br />