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a -7 3.6 31'9-z <br /> SSL SK SHIR# 111111111111 MINI <br /> � <br /> 1346775931SKS <br /> Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1,Generalor ID Number 2.PageCAL00034i of 3. m R e P 4.Manifest Tracking Number <br /> � 1 - - 006775931 SKS <br /> WASTE MANIFEST <br /> 5.Generajor's Name and Mailing Address Generators Site Address(if different than mailing address) <br /> Swiss AMer7Can Sausage Co <br /> 2251 Darcy Pkwy <br /> LATHROP CA 95330-8756 <br /> Generators Phone 209—$58-5555 <br /> s.TwtffqWtTR SYSTEMS INC U.S.ERA ID Number <br /> TXROO@081205 <br /> 7,Transporter2 Company Name - U.S.EPA ID Number <br /> 8.Designated Facility Name and Site Address CLEAN HARBORS SAN JOSE U.S.EPA ID Number <br /> 1021 BERRYESSA ROAD <br /> SAN ..ip' Ie , CA 95133 <br /> CAD059494310 <br /> 408-441-0962 <br /> Facilit}rs Phone: <br /> ga 9b.U.S.DOT Description(inducting Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.unit <br /> HM and Packing Group(if ani13.Waste Codes - <br /> No. Type Quantity WLNoI. <br /> I. NON RCRA HAZARDOUS WASTE Si DM �pL� P 35^c <br /> 0 (ABSORBENT WITH OIL) <br /> �a <br /> z 2. <br /> LJ <br /> 3. <br /> 4. <br /> 14.Special Handling Instmclions and Additional information TSD 6 SSI 56X 10590 tG <br /> 24H EMERGENCY#600-468-1760—CHiSK/TFI—Contract retained by generator conf¢-rsagenvy authori -y <br /> on initial transporter to ado! or substitute additional transporters on enerator's behalf. <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> marked and latseledlplacarded,and are in all respects in proper condition for transport according to applicable inlemational and national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> I certify that the waste minimization statement ides ified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is time. <br /> GeneratorsfOffemfs Printed(Typed Name Signature Mordh Da Year <br /> ' ►L 3 i IZ <br /> 16.International Shipments <br /> i— impo-rt to U.S. ❑Export from U.S. Port of enbylexit: <br /> ? Transporter signature(for exports only): Date leaving LLS.: <br /> W 17.Transporter Acknowledgment of Receipt of Materials <br /> Lu <br /> ai�Transporter 1 PdntedlTyped Name Signature Month Day Year <br /> �>ElrfxlC ,4�,c.E,.� %� eta, <br /> 11- <br /> IZ <br /> Z <br /> Transporter2 PrintedlTyped Name Signature Month Day Year <br /> C <br /> r <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space l Quamtity El El ❑Partial Rejector Ll Full Rejection <br /> IJ <br /> Manifest Reference Number <br /> 186.Alternate Facility(or Generator) <br /> - U.S.EPA ID Number <br /> V <br /> Facility's Phone. <br /> W 18c.Signature ofAltemate Facilly(or Generator) Month Day Year <br /> a <br /> z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> W <br /> p.1. 2, 3, 4. <br /> 20. +9�ted Facility Owner of Operator Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> yPad Name Signature Month Day Year <br /> r_ <br /> tj <br /> editions are obsolete. <br /> DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEIN <br />