Laserfiche WebLink
SSL SK SHIP#ix63 (I11lIHIliIIlfrnlul[tl��ttrtt�.�.n <br /> ZZyz^3j"d 007040OS6SKS <br /> - fease�nnt or ty L Form Approved.OMB No.2950.0039 <br /> UNIFORM HAZARDOUS 1.Generator 'Num6Bf—' —— gage 3.Em en Response Pone 4.Manifest Trocking Number �+��+ <br /> WASTE MANIFEST CAL000087982 0 =4 8=-�— U U� �-5 6-- iTK -- <br /> 5.Generators Name and Mailing Address Generators Site Address(if different than mailing address) <br /> San I Pak Inc <br /> 23535 S BIRD RD <br /> TRACY CA 95376-0000 <br /> Generators Phone: 209-835-3104 <br /> 6.Trtgspad�L�YCompg�y9ffq SYSTEMS INC us.EPAtDNumber TXR000081205 <br /> 7.Transporter 2 Company NameU.S.EPA ID Number <br /> CLEAN HARBORS ENVIRONMENTAL SVC INC. MAD039322250 <br /> 8.Designated Facility Name and Site Address CLEAN HARBORS ARAGONITE, LLC U.S.EPA ID Number <br /> 11600 NORTH APTUS ROAD <br /> RRRGQNITE , UT 84029 <br /> 435-884-8100 UTD981552177 <br /> Facility's Phone: <br /> ga 9b.U.S.DOT Description(including Proper Shipping Name.hazard Class,ID Number, 10.Containers 11.Total 12 Unr, Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity 'fdtrVoi. <br /> X 1 UN 1325 WASTE FLAMMABLE SOLIDS DM P F00 F005 D001 <br /> a ORGANIE, N.G.S. , (ACETONE, TOLbENE), <br /> aa, 4. 1, PG II j SIC) 352 <br /> w <br /> Z 2 <br /> LU <br /> O <br /> 3 <br /> 4 <br /> 14.Special Handling Instructions and Addihona!Information TSD-AG 79688085 SA23574 <br /> 1)ERG#133• <br /> 24H EMERGENCY#800-468-1760-CH/SK/TFI-Contract retained by generator confers a ency authori y <br /> nn initial transpni-tiar fn add on r s <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 labe!edlpiacarded,and are in all respects in proper condition for transport according to applicable intemationai and national governmental regulations.If export shipment and l am the Primay <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowle hent of Consent. <br /> I cenify that the waste min'un zation statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(A I am a small quar*y generator)is true. <br /> eroes Printedlfyped Name r Signature Month Day Year <br /> G c'd-d c f ou ,Y ILI <br /> 1 1fi.IntematonalShipments <br /> ❑Import to U.S. ❑Export from U.S. Port of entrylexit <br /> ? Transporter signature(for exports only) Date leaving U.S.: <br /> W 17.Transporter A,clmoMedgment of Receipt of Materials <br /> nspo 1 PdnteOped N gnature Month Day Year <br /> M ransport nnted/Typ Name u e t4onm Day Year <br /> t2,) Z <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space r' <br /> Quantity11Type El Residue Partial Rejection Ful!Rejec^c^, <br /> Manifest Reference Number: <br /> ,r„- 18b.Alternate Facility(or erator) U.S.EPA ID Number <br /> J <br /> U <br /> LL Facility's Phone <br /> W 18c.Signature of A!!emate Facility(or Generator) Month Day Year <br /> Q <br /> Z <br /> O 19.Hazardous Waste Reportwlanagemacf Method Codes(i.e,codes for hazardous waste treatment,disposal,and recycling systems; <br /> t 2. 3. 4 <br /> 14 <br /> � u <br /> 20.Des hated Faclllty Owner or Operator.Cenificabon of receipt of hazardous materials covered by me marlst except as noted in Item 18a <br /> PnntedR ed Name is tun Mond! Day `!ear <br /> WAMJ <br /> EPA Form 09-22( ev 12 ) Previous editions are obsolete. DESIGNATED FACILI TO EPA's a MANIFEST SYSTEM <br /> 083668%j1554826 <br />