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z`•. 1. U$EPA l0 NO (If Applicable) Dooument No. <br /> $I l L OF LAD I 7T :�" $ttippePs <br /> ST <br /> 3 <br /> Shipp e sNarnaand{ Ilf tK9ss �1 !@E( -nc <br /> �tO <� K 1 I B3 <br /> TRACY CA 95378-1183 <br /> a , _ 209 as 3104 <br /> Cvrtrpany Name 6. US.EPA ID Number A.Transporter's Phpne <br /> 8'.S <br /> S . 'Compan Na U$.(`R 10 Nurnt>ar B.Trensporters Phone <br /> ,. NAR ClRa <br /> ENVIRONMENTAL S4# INC.MADP 781-792-50M <br /> r ted <br /> Kadllty Name and Site Addr4ssW I 10. US SPA 10 Number C.FacIIIWs Phone <br /> a> AN i MMORS OF WILMINGTON LLC <br /> X37 EAST DF.NN I STREET <br /> WILMINGTON CA 90744 CAD044429835 310--835-9998 <br /> 11.Shipping Name and Description 12-Cont.inns 13. 14 <br /> Total Unit <br /> r. <br /> #M7 No. Type Quantity Wwor <br /> N-1'91% AERDSOLS, (EACH NOT E%CEIINS <br /> n X 1 DSOLSAC TTY) , 2. 1, UNIVERSAL WASTE— DM b p ` <br /> d. <br /> 15.Special Handling Instruction and Additional Information <br /> SK SHIP# 2231-90631 SA23 574 <br /> I)ERB#12b- <br /> 24 HR EA9AGENCY ##1-800-468-1760 (SK / TFI) <br /> RUTH AS "AGENT—FOR" BY BEN TO RETAIN LICENSED SUB CARRIERS AS NE&ESSARY <br /> DO-/PRF(_ A. 7995120/1490496 B. C. D. U <br /> A) NONE B) C) D) <br /> t5Lki2Sc:3� <br /> { <br /> Ilia.US DOT HAZARDOUS MATERIALS SHIPPJrR'$CERTIFICATION: .'rhis is w oerety that the sbovo- ed materials are propery daeii,%d,described:packaged,rria+keE and are in props[ . <br /> conddonfortra tionaccdrd %.thea liicbI. .Wbcm ttt. —t flan <br /> Printed(Typed Namp moruh Day Yoac s <br /> I Oft <br /> )CAV <br /> 16b.NON.;REGU LATED SHIPPER'S CERTIFICJATRQyt I certify the materiels descrW above or)Ala form we not sub ed to federal regulations for Transportation or Dispesal. <br /> Printed&yped Name Month Day Yoty a ' <br /> 17.7ian.porter 1 Acknowgadgement of Receipt of Materials <br /> kntedfryped Name Si natur <br /> 1$'7r�lgpprter 2 Acknowledgement of Recelpt of Materials <br /> ed Name Si <br /> Q9.Discrepancy Indication Space <br /> F <br /> far' <br /> !'RaGi�t3f.Owner or Operator Certification of receipt of materials covered by this form except as noted in Item 19. <br /> F ?l1slyped'lifama S nature <br /> � Month Day Year <br /> 24 HP.EMERGENCY <br /> 800-468-1760 <br /> ORIGt I NtTTaGENERATOR Fort No.of=sAz 1 t� 3. <br /> F. <br />