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SSL_ SK SHIP# 22934482 4 <br /> 00718199' bSl <br /> Please print or type. FormApproved. OM o. 2050.0039 <br /> UNIFORM HAZARDOUS 11 . GeneratorlDNumber 2. Pae 1 of 3. Emergency Res nse Phone 4. Manifest Tracks g Number <br /> WASTE MANIFEST GAD982336141 1 - 800- 4t8 - 1760071 <br /> 10 SKS <br /> 5. Generator's Name and Mailing Address Generator's Site Address (if different than mailing address) <br /> Murrayy Trailers A Division of Hogan Mfg . , Inc . <br /> 1754 E . Mariposa Road <br /> STOCKTON CA 9505-7790 <br /> Generator's Phone: 209- 838-7323 <br /> 6. Transporter 1 Companyy�Name U.S. EPA ID Number <br /> SAFETY —KLEEN SYSTEMS INC TXROOOOB1205 <br /> 7. Transporter 2 Company Name U.S. EPA ID Number <br /> CLEAN HARBORS ENV SVC INC . MAD039322c^^.5th <br /> 8. Designated Facility Name and Site Address CLEAN HARBORS ARAGONITE , LLC U.S. EPA ID Number <br /> 11600 NORTH APTUS ROAD <br /> ARAGONITE , LIT 84029 <br /> UTD981 552177 <br /> 435-- 884 -8100 <br /> Facilites Phone: <br /> ga, 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10, Containers 11 . Total 12. Unit 13. Waste Codes <br /> HM and Packing Group (if any)) No. Type Quantity Wt.Nol. <br /> 00 W, QKI NON— RCRA HAZARDOUS WASTE , SOLID , DMP P 352 <br /> ( PAINT BOOTH FILTER ) , 300 <br /> Z 2. <br /> w <br /> 3. <br /> 4, <br /> 14, Special Handling Instructions and Additional Information TSD : AG 8098306E MU 17758 CSG <br /> 24H EMERGENCY# 800- 468 - 1760— CH / SK / TFI —Contract retained by geerl�`t' rr - conTe`rs e`Ficy authors y <br /> 15. GENERATOR'SIOFFEROR'S CE MF12CATION: 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 labeledlpiacarded, and are in all respects in proper condition for transport according to applicable internati nal 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 onsent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b lit am a small quantity generator) is true. <br /> Generator's! 8eror's Printedffyped Name Signature Month Day Year <br /> ,� lic 30 <br /> 16, International Shipments <br /> ❑ import to U.S. Export from U.S. Port of entry/exit: <br /> K Transporter signature (for exports only): Date leaving U.S.: <br /> W 17, Transporter Acknowledgment of Receipt of Materials <br /> 2 Trans e 1 Printe0ype , me Signatu Month Day Year <br /> a VA4 115 M1 30 <br /> Z Transporter Printe /Typed Name Signa Mo Day Year <br /> 1 INN <br /> low (� .v � � <br /> 18. Discrepancy <br /> 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection <br /> Manifest Reference Number: <br /> 18b, Alternate Facility (or Generator) U.S. EPA ID Number <br /> J <br /> V <br /> L<E Facility's Phone: <br /> W 18c. Signature of Altemate Facility (or Generator) Month Day Year <br /> Q <br /> z <br /> N19. Hazardous Waste Report Management Method Codes (Le', codes for hazardous waste treatment, disposal, and recycling systems) <br /> 2. <br /> 20, Designated Facility Owner or Operator. Certification of receipt of hazardous materials covered by the manifest except as noted in Lem 18a ae <br /> Printed/TyPkJi 1 �` �/ ' r I Sig u -jk�"— <br /> Mo Day <br /> I ffi <br /> EPA Form 8700-22 (Rev. 12A7) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br /> 1 } 858 � 383 / 1807 ? .3ih <br />