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SSL SK SHIP# 229107915 11111111111111111111111111111111111111111 <br /> 007181585SKS <br /> Please, print or type. Form Approved. OMB No. 2050-0039 <br /> UNI ORM HAZARDOUS 1 • Generator ID Number 2. Page 1 of 3. me en R s nse P e 4. Manifest Tracking Number <br /> W RM MANIFEST CAD982336141 -�0e �+ 8- 1 60 $ $ <br /> . , <br /> 5. Generator's Name and Mailing Address Generator's Site Address (if different than mailing address) <br /> MurraX Trailers A Division of Hogan Mfg . , Inc. <br /> LI ;3'4 Ma ITIaMpusa Road <br /> STOCKTON CA 95205-7790 <br /> Generators Phone: 209'83a-7323 <br /> s. TW YC'Pa em SYSTEMS INC U.S, EPA ID Number <br /> TXR000081205 <br /> 7. Transporter 2 Company Name U.S. EPA ID Number <br /> CLEAN HARBORS ENV SVC INC . MAD039322250 <br /> 8, Designated Facility Name and Site AddressU.S. EPA ID Number <br /> CLEAN HARBORS ARAGONITE, LLC <br /> 11600 NORTH APTUS ROAD <br /> ARAGONITE , UT 84029 <br /> 435-884=8100 UTD981552177 <br /> Facility's Phone: <br /> 9a. 9b U.S. DOT Description (including Proper Shipping Name Hazard Class, ID Number, 10. Containers 11 . Total - -- _12. Unit <br /> 13, Waste Codes <br /> HM and Packing Group (it any o. Type <br /> 1 • NON-RCRA WIAItDOUS WA5 E , SOLID , DM P 352 <br /> 0 ( PAINT BOOTH FILTER ) , <br /> z 2. <br /> W <br /> 4? <br /> 14, Special Handling Instructions and Additional Information TSD : AG 80732283 MU 17758 CSG <br /> 1 oLAe S '+ <br /> 24H EMERGENCY#800-468- 1760-CH / SK/ TFI -Contract retained by generator confers agency authori y <br /> on initial rtpr to add or suhstitutp additional tranciportors <br /> ra' nr15, GENERATOR'SIOFFEROR'SCERTIFICATION: 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 labeled/placarded, and are In all respects in proper condition for transport according to applicable international 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 EPAAdmowiedgment of Cont <br /> I certify that the waste mJnirnIzafl9fG ta ant klentifiedjnkilCkR 262. 7(a) (if I am a large quantity generator) or (b) (d I m a small quantity generator) is true. <br /> Generas(Offeror s 'nt N e Signature Month Day Year <br /> FJ— 16. International Shipments ❑ import to U,S. <br /> ❑ Export from U.S. Port ofentry/exit: <br /> ? Transporter signature (for exports only): Date leavin .S <br /> W 17, Transporter AcimowledgmentofReceipt o atedais <br /> 1 Trans a Pn Na a Signature Month Day Year, <br /> a '2 S <br /> N Trans erg PFn Name Sign M Day , ar <br /> 18. rsaepancy <br /> 18a. Discrepancy Indication Space EJQuantity ❑ Type <br /> ❑ Residue ❑ Partial Rejection I Rejection <br /> Manifest Reference Number: <br /> C 18b, Alternate Facility (or Generator) U.S. EPA ID Number <br /> J_ <br /> V <br /> FacilitysPhone: <br /> 18c. Signature ofAltemate Facility (or Generator) Month Day Year <br /> Q <br /> Z <br /> y19, Hazardous Waste Report Management Method Codes (Le., codes for hazardous waste treatment, disposal, and recycling systems) <br /> G 1 . 2. <br /> 20. Designated Facility Owner or Operator. Certification ofrecelpt of hazardous materials covered by the manifest except as noted in Item f8a k <br /> Printed/Ty S lure Day Year <br /> EPA Form 8700.22 ((Rev. 12-17) Previous editions are obsolete, L DESIGNATED FACILI TO EPA's e•MANIFEST SYST M <br /> 1 ) 8582383/ i807330 r , tr <br /> s. M <br />