Laserfiche WebLink
MDec. 10, 2019110: 16A <br /> I-ShIppetes US EPA ID No.(IfAI)PI10able) Document No- 2,Page <br /> BILL 6F.,.LADING/MANIFEST of <br /> 3.ShIpper's t4ama and MaIllng Address C,,31 Wf-qt C"'r?novett* GlLtt-,-�nrj <br /> 'i,— <br /> MANTECA C, 95337-6120 <br /> 4,Shipper's Phone ?-,S!Z 6 <br /> G.Transporter 1 Company Name 6. US FPA ID Number A.Transporter's Phone <br /> �MELIY-N-LEN 8YEITEMS INE JXROIAMMAIR09 <br /> 7,Transporter 2 Company Name 8. US EPA ID Number B,Transporter's Phone <br /> 0.Designated FacIlIty Name and 81te Address E!V6 10. US EPA ID Number C.Facility's Phone <br /> NEWARK r-A 94MO COD9A06874 18 "5 10-795-4400 <br /> 11.Shipping Name and Description 12.Con I8 Ines Tot13 <br /> al nU14f, <br /> , <br /> HM No. Type Quantity WUYoi <br /> 1—:(Q1J1)) (VAC-1111 WATFAI <br /> BLUDBE') (NOT USDOT/110T um"PA4-bol'A.W.,D) TT <br /> (NOT CA REBULATED) <br /> b. <br /> H <br /> E <br /> d. <br /> is.Special Handling Instruction and Additional Informallon <br /> SK GHT.Pif 2301,49DZIi <br /> 8i82463C-) <br /> 1, PEI# ALITH TCJAr—TAIN ADD71— C <br /> A R R I R,P.q <br /> A) Nf)Nl;;: 5) C) D) <br /> Mtrials are propody;ra-MR00,=PaVrped aotged and labeled and ate In OMMY. <br /> Ifis.US DOT HAZARDOUS MATERIALS SHIPPEFVS CERTIFICATIOW 'rh'"ca 46 , rT.,,;,,too <br /> condillon for 10 • <br /> Printedrryped Name ftlonth Day Year <br /> 16b,NON-REGULATED smiPPERIS CERTIFICATION! I cnlrtl�the tralerillis dqz�cfibad above!on We form afe not sub*l to(aderel regulations I&Transportation or Dlop000l. <br /> PrInIedfT:y.6W,Name Month DAY Year <br /> K <br /> IN <br /> 7 K�Wjm K <br /> T 11.Transporter I Acknowledgement of ReGelpt of Materials <br /> R <br /> A ZtedfTyped Narne Sign Month Day Yeer <br /> N <br /> ar <br /> op 18.Tra;spkj;r 2 Acknowledgement of Rkee It of Materials —1 <br /> R Signature Month DAY year <br /> T PrinledrTyped Name <br /> 6 <br /> R I <br /> 19.DIscreparloy Indication Space <br /> A <br /> L 20,FarlIlly Owner or operator,Cerlifloatlan of receipt of materials covered by This form except as noted In Item 19, <br /> I <br /> T <br /> Y PrInteO/Typed Name Signature &fpnlh Day. Year <br /> 11111*1111OZ-VOINN <br /> GENERATORS COPY FORM NO.0 1 1-90291(03/2015) <br />