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• SRL CSG: <br />1. spedal NandMg IratrucOars and Additional IntormaOon TSD : SCR <br />i' <br />24H EMERGENCY#800-468—i760—CH/SK/TFI—Contract retained by generator conters �I�attth�dorl Y <br />on initial trans orter to add or substitute additional trans otters D nI and am Hera adlamllrePckA <br />above the Proper Ml�a9 <br />declare Owt ilnddonre contents otlNs cmtsigment are fuYyand eauralety descdbad by <br />5. GENERATOR'3tOFFEROR'SCERnflCAnON:lheraby toa b�j3_850nalamnalimalgovernmentalregulaems.ItezportsfYprnant <br />marked and IabeledlPlawnled,and are m a1 respects n pro' Itsfor for f thepart attaacwched <br />EPA nt of Consent <br />EVodar,Iw0jfy that the contents of Ods eonsgrarant wdamto Its temudthe aOached EPAAdutaniedror dl am a sinal quantify9cmerabr)is true. <br />d I am a large q b generator) @) ( MonOt Day Year <br />uanti <br />IcaO(YtnatlhewastemhirrizationstatementidentitredN40CFR262.27(a)('.Q � l <br />aptslpRas PrirriadlFed Name <br />lemalionaleJ\Sh`tpne�ds from U.S. Pat of enlryMsk: <br />16. In <br />❑ Impa1 to U.S. Date leaving U.S.: <br />[ `) <br />~ 16. Disaepancy ❑ ftesidw El Pu Rejection El FuA RejecWn <br />16a. DisaepancY IndicaWn Space El( -ow 0Type <br />Maritesl Reference Number: U.3. EPA1) Number <br />19. Hazardous Waste Rggatlaanagemae mr:��,,• ••,,,,...,.._ -- - - <br />2. H141 3' H141 <br />u1 <br />a ' <br />20. Designated Fad6ty Owner or Operator: Cacatiar of recelW d hazardous materials covered by the raardte t eewpl as nded in Item 13a <br />Prn >Rad sate <br />r�i ob�1 DESIGNATED FACILITY TO <br />PI41W-12,4) �"P116 iiois1 60s ! 3) 14941/156023 23 <br />limitsKll��gl���ll <br />551_ SK SHIP# 2' 9567768 <br />0 0 7 1 �7rrdApprboved. DMeNo.205HO <br />epdntorlype. ' LManifeslTraoMingNumber ��� <br />2.P /d 3. mgyR 007180860 <br />lD Number 1 1—tRC+w 4607 r o Q p <br />1. Generator TXR000091205 <br />UNIFORM NA7ARDOUS <br />WASTE MANIFEST <br />Generators S to Address different than may' address) <br />SYST�MS, INC. <br />S. Generators Name and Ma Address INC. <br />SYSTEMS, <br />SAFETY—KEEN <br />5050 SRt_IDR BLVD <br />SRFETY—KLEEt <br />PQ BOX 555 CA 95369 <br />SALIDR CA 95368 <br />SALIDR 209-545-1011 <br />-----US TXR000091205 <br />Umber <br />Generatot's Piano: <br />6. SYSTEMS INC <br />' <br />U.S.EPAIDNurotw MRD039322250 <br />1.Transpoder 2cName <br />Gt_EAN R�AORS ENV SVC INC <br />H R <br />U.S.FPAIDNrarihar <br />e DeS{ynaedFadayHameandsteAddress SAFETY—KLEEN SYSTEMS, <br />6000 88TH STREET <br />INC. <br />SACRAMENTO <br />CR 95828 CR0000084517 <br />916-386-4913 <br />Faa Phone:10. <br />DOT DesalpOaa (IrK10 9 Proper ShppMg Name' Hazard Gass, ID Number, <br />Containers /{.Total 12.U61 13. Waste Codes . <br />No. Toe Quantity wuw. <br />9a. 9b. U.S. <br />HM andPecYJn9Gt°uP(danY1) <br />t <br />DM t, i34 <br />2. NON—RCRA HAZARDOUS WASTE, LIQUID <br />U KARTS WASHER SOLUTION) <br />+ <br />(ARUEOU9 <br />DF G 134 <br />a. to�Iwo 5 PARTSDWASHERSSO'LUTION)LIOUID <br />I <br />Q <br />• SRL CSG: <br />1. spedal NandMg IratrucOars and Additional IntormaOon TSD : SCR <br />i' <br />24H EMERGENCY#800-468—i760—CH/SK/TFI—Contract retained by generator conters �I�attth�dorl Y <br />on initial trans orter to add or substitute additional trans otters D nI and am Hera adlamllrePckA <br />above the Proper Ml�a9 <br />declare Owt ilnddonre contents otlNs cmtsigment are fuYyand eauralety descdbad by <br />5. GENERATOR'3tOFFEROR'SCERnflCAnON:lheraby toa b�j3_850nalamnalimalgovernmentalregulaems.ItezportsfYprnant <br />marked and IabeledlPlawnled,and are m a1 respects n pro' Itsfor for f thepart attaacwched <br />EPA nt of Consent <br />EVodar,Iw0jfy that the contents of Ods eonsgrarant wdamto Its temudthe aOached EPAAdutaniedror dl am a sinal quantify9cmerabr)is true. <br />d I am a large q b generator) @) ( MonOt Day Year <br />uanti <br />IcaO(YtnatlhewastemhirrizationstatementidentitredN40CFR262.27(a)('.Q � l <br />aptslpRas PrirriadlFed Name <br />lemalionaleJ\Sh`tpne�ds from U.S. Pat of enlryMsk: <br />16. In <br />❑ Impa1 to U.S. Date leaving U.S.: <br />[ `) <br />~ 16. Disaepancy ❑ ftesidw El Pu Rejection El FuA RejecWn <br />16a. DisaepancY IndicaWn Space El( -ow 0Type <br />Maritesl Reference Number: U.3. EPA1) Number <br />19. Hazardous Waste Rggatlaanagemae mr:��,,• ••,,,,...,.._ -- - - <br />2. H141 3' H141 <br />u1 <br />a ' <br />20. Designated Fad6ty Owner or Operator: Cacatiar of recelW d hazardous materials covered by the raardte t eewpl as nded in Item 13a <br />Prn >Rad sate <br />r�i ob�1 DESIGNATED FACILITY TO <br />PI41W-12,4) �"P116 iiois1 60s ! 3) 14941/156023 23 <br />