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3 SSL SK SHIP# 219566332 <br /> ! liillil �14� ; <br /> DosW� a <br /> Please print or type.(Form for use on elite(12-pitch)typewriter) Form �No. : <br /> UNIFORM HAZARDOUS1.Generav 1D Number TXR�O$81 � 2. 'I of 3f h,''g 5 i Yhrdfast Trad&V <br /> resp 05522 ;, SKS <br /> 5. I TEMS, INC, $ TY-fit S3r� )INC. <br /> PO BOX 555 5050 SALIDA BLUR <br /> i l}A CA 95368 SALIDA DA . CR 9 , <br /> 299-545-1011 <br /> GaerabYs Phone: <br /> e T�14�r�a SYSTEMS, INC, u.s.EPA wNr�tber TXR0812Ql ` <br /> 7.T anspor 2 nY Name U.S.EPA 10 Number <br /> 2 <br /> C � <br /> - <br /> B.Designated Factty Name and sae Aedreas TY—KL.EEN SYSTEMS, INC. U.S.EPAtD lhnldter <br /> 60M 88TH STREET <br /> SACRAMENTO , CA 95828 <br /> 916-386-4913 £'>R�t0�d0084517 <br /> F s Phone <br /> gb-U.S.DOT Oesatpbon MOiding Proper N Name,Hazard Clens,10 Number. ]0. 11.Tota! 12.tlrnt <br /> �� ��d 13.Waste Coats <br /> acid Pac*kV Glop(d anY)) 4o Typo g . <br /> DOL D035 212 <br /> IdQTPRTrll <br /> Pam lob I <br /> 3. V n !2 tr-zi iun S� ti,»�- �L�-�+� rvl��.�T�ct�, � ��'1 � <br /> d_ <br /> i <br /> tnsouctions and AddWW Information TSD:SCA SAL CS$I <br /> 1}ERG#128.2)ERG#128 <br /> 24 HR EMEAGENCY #1- -469-1769 (SK I TFI) <br /> AM AS "A13ENT-EOR" BY BEN TO RETAIN LIQ SUB CARRIERS AS NECESSARY <br /> 15. G&i RAATt V0FF8WR'S CERTIFICA't M: I hereby deme#0 Nie CmW is of tlts cmrttdptwwg are kk WW Y d abate by"Proper O name,ar d arm Wssifxsd,pwAaged, <br /> t98tRedaWtabalrtdiptacarded,and are in all respects tt proW wnd Mon for transport according b eppbum it>Mnabonal acid nabortel governmental regrr',ations."export wupment and I am the Primary <br /> ExporW,I c *thm me-ontmrts of this Esq m)ent co,*v n to ete terms of the atm rPA Aclutowledg w t of COMM <br /> I certify lftat the waste rw m zatian sm�mw.identified in 40 CFR 26227(a)W i am a large2araity geOPWR64(b)(d I am a aMW quangY generator)is true. <br /> Mordh Day Year <br /> slfNfaot's Pra�drTyped Matte � aS <br /> S <br /> 16.intamat rmat D Import to U.S. ❑Export from U.S. Pat of er>;ry*A <br /> Transporter signature(tor exports ozdy): Date Woong U.S <br /> 17.Trartaporter Aduv*WpwY of Rem of MalerWs <br /> 1 Printed/T�flan» Monro Day Year <br /> Ito larIM <br /> Month Day Year <br /> �- � T 2 ur <br /> . .Di-epa-y <br /> Tyne <br /> i83.0issreparuy k6cabon Spece ❑ ❑Res due D Partial Rejer at ❑Full Re)txtion <br /> D _ <br /> Man torsi Raterer ce Number. <br /> U.S.EPA ID Number <br /> 16b.Attemate FaciW for Generator) <. <br /> a <br /> tor. faalrty`s Pliorte. MaMh Dey 9 . <br /> 6c. gne4va d Alternate fadlity(or i—M—W <br /> S2 19.Hazardous Waw RBpI M r*M Method Coon(ia.,axles for hazardous wash treatment,disposai,and recycling systems) <br /> c 1. -- <br /> 2. i l <br /> 20.Des atoci faa7ity Oamer or Operate Cert fxation ori receittt tfazarrbus ma eras care ed by lite ntanAe ti exceplos noted M Rem AM nth Day ear <br /> ESIGNA FAClL1TY TO DE&TIMEAMN S E(IFR IU <br /> `' <br /> -741130 q 05137 <br />