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II <br /> Plealee print or . Form for u'e on elite 12 Form t No.2OSO pt73p <br /> L4NK M NAURDOU3 1.Gemwalu D Numdw2.Poo' <br /> d 3.Ertsperxy Raepa+ee Ph" 4 Mem{{lbw i nn <br /> CAL000018659 2 (800)326-1221 0 14�1V <br /> SEARS HOLDINGS CORP. / DAWN JESS KMA TR * 3174 / !ICAC CLERK <br /> 3333 BEVERLY ROAD 2180 E. MARIPOSA RD. <br /> HOFFMAN ESTATES IL 60179 STOCKTON CA 95205 <br /> Gwteraiore Imo: (209)348-6205 GKH: 117 82 <br /> 5:Tramportor 1 company ft)" U.S.EPA D Number <br /> HERITAGE TRANSPORT, LLC / SIGNAL HILL IHD058484114 <br /> S. <br /> t A 'T 12 Aero UQ D l 5 <br /> 8.Desowbd 8°*tyancl Sb Addtaee U.S.EPA D Number <br /> HERITAGE ENVIRONMENTAL SERVICES, LLC <br /> 5122 EAST STOREY ROAD AZDo81705402 <br /> COOLIDGE, AZ 85228 <br /> F s Pana: (520)723-4167 <br /> W. 9b.U.S.DOT DaKilpam(trrddYy Proper Stupptg Name,Hazard Cbee,lD Number, 10.Cauaitara 11.Trial 12 Uf* 13.Waste Coda <br /> HM NO PK"C-V(8✓r Y)) No. Type Quantity WU1kl <br /> 1. <br /> o X RQ UH1950,WASTE AEROSOLS,2.1,(DO01 D039), <br /> ERG*1126 <br /> 2 <br /> X RQ,UN1978,WASTE PROPAHE,2.1,(Do01) ,ERGM115 321 pool <br /> a9r &C1P <br /> 3. <br /> X R$ UK1993 WASTE FLAMMABLE LIQUIDS, N.O.S., <br /> � <br /> 3,POM,(PAIIlf'),(D001),ERG*128 ©(V <br /> 4. <br /> X RQ UN3139 WASTE OXIDIZING LIQUID, H.O.S., 141r <br /> 5.1 PbII (HYbROGU PEROXIDESODIUM p <br /> 14.Speolailtadb InNndan WonTm lion <br /> 1.118_039578 LDR 2.W14_Q439584 LDR 3.W12_Q439582 LDR 4.W9_Q439579_LDR <br /> (1134336JG <br /> 15. GENEMTORSKIFFEROn CERTTF"TON:I hereby dK*e that to oarwVs of this owdownerx ars hiy and sodraley desaibed above by the proper 00pig name,and aro daaeiled,p Japed, <br /> met fud u+d WbWodlp*urd d,and ere in M raepecta n proper condlion lw Ywrpon arzordrg to spocable nbrnatlortd and nadord governmental raguWora,I export dupmerd and I am the Primary <br /> Expabr,l oeray rtat the catlerdt d ft cone0.,wt mnlortm m the tamed the attached EPAAdmowledpot d Cortaerd. <br /> I tarty dM ate wage rtuMmmutalon amWraa idertafed in 40 CFR 26227(x)(M I am a large quaMly gwarefa)a(b)(if I em a arta!gtwttty gerteralu)ie true. <br /> aY Yew <br /> 16.1-ainuloMShipmerft <br /> ❑import m U.S. ❑Export bort U.S. Port of erdrylerdt <br /> T fa• Jeb U.S.: <br /> 17.Tranepotbr Adwoledpeol of Rmo of MawWa <br /> 1 NameNam Day ser <br /> nuapMer 2 PNemoMona, Day <br /> ew <br /> I 1-?JCA Loa <br /> 18. <br /> 18a.Deaepw"Indication Space a."y ❑Type ❑Rrxadue ❑Partial RWcdon ❑Ful Rq dfon <br /> Mar449 Relera"Number <br /> 18b.Apemate Faaily(a Generator) U.S.EPA ID Number <br /> J <br /> U <br /> Q <br /> LL <br /> FaWs P1w o, <br /> W 16c.Slpnaaxe dAlbmeb Feoiy(or Geraalor) Month Day Year <br /> 19.Huando ur Wes*Report Marg rnant Med d Coda(ie..codes for hazardous wasta beaenent,disposal,and recyc"sysbmal <br /> W 1 Z. 3 4. <br /> d <br /> H141 H141 H141 H141 <br /> 20.Dwou bd Feely Oma or Operator Ca"caeon of d hazardous mow"comm by rite,7w*W except as noted in ham 1 as <br /> Nene Month ay Veer <br /> VlA. BIA-QL17� i!j4&j A4, lirrf <br /> EPA Form 87W22(Rev.3-05) Previous editions are obsolete. DESkNATFD FACILITY TO DESTINATION STATE(IF REQUIRED) <br />