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S-SL SK SH I H# 226022072 <br /> 'lease print or type.(Form designed for use on elite(12-pitch)typewriter. Form Approved.OMB No.2050-0039 <br /> UNfFORM HAZARDOUS 1.Generator ID Number 2.Pagu 1 of 3.Etrorgency Response Phone 4.Manifest Trackin Number <br /> -- 1NASTEMANIFEST — --- CAR1000083287 1-8001-46.8-1760 <br /> Generators Name and ACaITI–ng <br /> Swift Transpportation Co <br /> 901 Darcy f�k�fy <br /> LATHROP CA 95330-8764 <br /> Generatces..P_hone:. . 209-858-7027 <br /> 6.Transporter 1 Company Name <br /> SAFETY—KLEEN SYSTEMS INC U.S.LVA IDNumber <br /> TKR�Q1�1��31.��15 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> CLEAN HARBORS ENVIRONMENTAL SVC INC. i�1ADt?f�93����t� <br /> 8.Designated Facility Name and Site Address GLEAM HARBORS ARASON I TE, LLC U.S.EPA 10 Number <br /> 11600 NORTH APTLIS ROAD <br /> ARAGONITE , UT 84029Facility's Phone: 435-884-810 UTD981552177 <br /> ga, 9b.U.S.DOT Description{including Proper Shipping Name,Hazard Class,ID Number, 10-Containers 11.Total 12.Unit <br /> HM and Packing Group(if any)) 13.Waste Codes <br /> No. Type Quantity Wt.Nol, <br /> X 1 NP3077 HAZARDOUS WASTE, SOLID, N.O.S. DM Ali P DU.352 <br /> (BMENE), 9, PS I I I <br /> i <br /> IL <br /> Z 2. <br /> IL <br /> 19 <br /> 3. <br /> 4 <br /> i <br /> 14,Speciai Handling Instructions and Additional Information <br /> TSD:AG 77248897 SW10083 CSS: <br /> 1}ERS#171 <br /> 4H-.EMERG�NC-Y#8(6Qt-468—k760-CI4/SKfTF-1--E-f nti-ect- rota-inecf I,y- enerat-o—cz7o ir {s e f:aut-horily <br /> 9 <br /> 15. GENERATOR'SfOFFEROR'S CEE�TIFICATtON. I hereby declare that the contents of this consignment are fully and accurately described ove by the proper shipping name,and aro classified,packaged, <br /> marked and tabeiedtplacarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(h)(if I am a small quantity generator)is true. <br /> enerator` erors Pnntedffyped Name Sfgnature Month Day ear <br /> J1/44 C <br /> T1 16,International Shipments <br /> F' ❑Import to U.S. ❑Export from UJrPort of entry/exit: <br /> _ Trans der signature(for exporlsonf <br /> Date leaving U.S.: <br /> IX; 17.Transporter Acknowledgment of Receipt of Materials <br /> LLI <br /> F- <br /> 0:. Transporter 1 PrintedlTyped Name Signature ont ay ear <br /> Z4 Transporter 2 PrintedlTyped Nar^ Signature = Mon ay ar <br /> r18bb. <br /> repancy <br /> crepancy Indication Space ❑ Quantity F-1 Type El Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest Reference Number: <br /> f- ernate Facility(or Generator) U.S.EPA ID Number <br /> J <br /> 1) <br /> iFablit's Phone: <br /> Z� <br /> iu 18c.Signature of Alternate Facility(or Generatorl Month Day Year <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> LU <br /> 2 3. <br /> 4. <br /> 20.Designated Facility Owner or Operator:Cortification of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> Pr nted petl me Sign a Month Day Year <br /> EPA Form 8700-22{Rev.3-05Previous editio are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED} <br /> 1)73-, 1302 <br />