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---' SSL SK SSHIP# 22BR29339 <br /> 0070401068KS <br /> Please print or type. E� Ragpp }tea (� /Farm rovedd...OMB No. <br /> �ZM-0999 <br /> UNIFORM HAMRDOU3 1.Gemrorar 0 Number CAL00040fs390 2.Page 7 W 3.1—ef %r Pl lb1D paU 7 la N O [J i7 A <br /> M be <br /> WASTE MANIFEST 1 tSYTW <br /> S.GsneratorsNamsandMaiNgAddress GemrelsfsSireAddress d"finerdEhanmallingaddmsa} <br /> Diestl Direct West Inc <br /> 3861 Duck Creek Dr PO SoH 31086 <br /> STOCKTON CA 95215•-7956 <br /> Generators Pham: 916-857-1000 <br /> e Tr�J Y—tSLy��N US.EPAIDNumbnr <br /> SYSTEMS INC TXR000081205 <br /> T.Trvspmw2Nrvpanr,Narnn U.S.EPAID <br /> CLEAT! HAR80RS ENVIRONINE'NTAL SVC INC. MAD039322250 <br /> 8. gvatedFarrityNamaandSitenddresa CLEAN} HARBORS SAN JOSE U.S.EPA IDNumW <br /> 1021 DERRYESSA ROAD <br /> SAN JOSE CA 951,33 <br /> 408-441-0962 CAD059494310 <br /> Fedi F'none: <br /> 9a, 9b.U.S.00T Descrptlon�ricludinq FmMShlpping Name,Hazard Class,IDNember, 10.Canlamm 1L 70tnl 12.Unil 1tl Waste c das <br /> HM amlpaddngGrotrp("any)) No. Type Quantity ". <br /> 1' NCIN RCRA HAZARDOUS WASTE SOLIDS, (USEDDM P 352 <br /> OIL AND ABSORBENTS) <br /> 49 <br /> a. <br /> 4. <br /> 14.Special HaAdinglnaWrticaaan lonal Informagon TSD.-SJ 79806679 D121596 ff CSG: <br /> It 676 <br /> 24H Er4ERGENCY#8041-468-1760-CH/SA/IFI-Contract retained by generator confers agency authari y <br /> in a a r io trans or ers G era or's behalf. <br /> 15, GENERATDRSn1FFEROR'SCERTIFIGATION1Ihereby dedareNalthe wnlrn+sofINS v0hignmentate fUlyand aramlelydesraihedabove byIke proper shippinpnamn,and are dassl&ed,packaged. <br /> marked and lahetlrdfplacaidatk and are in all respects in proper co%Mon for hanspodaowrft to eppycablelnleinetlosal and natlonal gavernrnenad regtdallons."export Odprnsnl and I am gra Primary <br /> Expater,I coA1ty Ihet the panynls bf Ihls oomignmard nonimnl W the lama of dw a"acbae EPAAcWrowladgmenlaf CwaaM. <br /> t certify Ihal the waste minW aeon slatenlant IderdNiad In 40 CFR 2a227(a)("I am a largequartly genaralar)or(b)91 amt a emttll quw4p amtor)Is tore. <br /> GeneraWVOlferors PrinkZfWa Name ue aA '-" ,an Day Year <br /> '-(, 14- 1/2 1101 <br /> kriernalkerel Shonants ❑inwlaU.S. ❑Espprtfrmn .S. MoakyNxlU <br /> F <br /> a Transpanersignetum(for am"anl): Date leavN U.S.: <br /> a 17.TmrepoderpckrwNWgnwtofReoelpt01Materials <br /> T[ rte PdMedll)ped me Sdgnature onlh vay Yesr <br /> VIA <br /> 1 Pd S'9 th Year <br /> n Name r. s �� t <br /> ta.Dleva%rcy <br /> 1aa.lNewpamylndlradnrSom ❑Ot nthy ❑Type ❑Aea3dua uPmkalReiectlon LJ I'dRe)ocllan <br /> Manifest Nelarenm bhm7ber. <br /> lab.AlWmaW Faaliry(or Generators US,EPA ID Number <br /> Fadlity's Pltmis: <br /> 18C.SIgnaareotNtert7ele arNgyar eneralur) Mont Pay Year <br /> -0—z, 19.Hazardous Wazie Re rt MarregementMedmd Caries(i.e.,codes fa hamrdous waslatreahurd,diaposal,and mcyd{gg kms} <br /> 20,Desonated Paddy r0pamloc n ofhaxardousmateriabrwv <br /> PriftdrrypidNameSIgnakie <br /> \ _ ^•�+ <br /> EpAFbrm8700.22(Reu.12-17 Pre, se n sdele. DESIGNATED FACILITY TOEPA'sa-MAN! EST S STE <br /> 1)7636?04/99967 <br />