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�Sl Y 13Y SHIP# 227493522 <br /> ootsr7tsa � z � tc� <br /> P(erse rint or type. Form Approved.OMB No.200d0039 <br /> UNIFORM HAZAtZDOUS 1.Generator lD Numb-- T X 80121 IQt812915 2:Pa9v of 3.jEgtl y t3t�s aeaBt� 4 Ma <br /> nifest Tracking <br /> Number ry �/ <br /> WASTE MANIFEST V V 6 t 16 8 5 2 SKS <br /> 5.'a"ffft' ft AftT INC. r "�4 I NC. <br /> Po Pax .5155 wt11. Tap Ra_irix <br /> SAL I DA CA 953E� <br /> Gerherettlr's Phone: 209-545-1011 ;SALIDO CA '95368 <br /> . .. _ <br /> B:Tr��r)t►ocn SYSTEMS INC U.S_EPA ID Number Tl{ROA 12�i5 <br /> 7.Trattsrpr�r„�C t"✓a,., ENOTRONMENTAL SVC INC. 11:s.I PAiDNumrber i+tAl} 393c�c2513 <br /> B.Det�watatretd Fa 11ity Nemie and Site Address at°1• _1 — s u.S.EPA IO Nhmt bff <br /> 6000 88TH_.STREFT <br /> SACRRMENTO CA 95828 <br /> �tif,-�3�fi-49]3 r��lr.�tc��r�4517 <br /> Fw (a Pnww. <br /> ga 9b.U.S.DOT Description(indudke,Piper$hippkg Name.Hazard Clams,ID Number, 16:Containers 11.Toth 12.Unit 13.Waste Cots <br /> Hm ww Paddn9 Gov(if any)) No. Type Quantity ' 1,zniw. <br /> 2 (AP.UEtlUS PAR WASHER SOLUTION) � ,' <br /> 4. <br /> 14.Special HantlNno InslNdions and Additional information y .* .. <br /> 'artI EPIERCEII Y#NO0•-468-1760-CHISK/TSi—Contract retained try. genet at nr vonfer's agenvy author y <br /> .on ini.t tal i:r•<iirlsporter to .add or' substitute additional transAor::ers on genpifator's behalf. <br /> 15, GENERATOR'SIDFFEROR'S CERTIFICATION:Ihereby declare that kte contents of this consignment aha Easy and accurately descrihad above by the proper shipping name,and are dassified,paclraW, <br /> marked and lalmladlpisoarded,aid are in alt respects in proper condition for transport according to applicable lntema8ataland national governmental regulations.if ezpoit shipment and I am the Primary <br /> y R9 Aaknowledlimem of Consent. <br /> t;Xpgftar,l txiU diet the t96mehtS tlfktl5 S`ISrJ�nnrent txrlddrrrr'�the Of the atfa(918'd EPA <br /> Ice*khat the waste minimization statement identified in 40 CFR 262.27(8)(IPI am;atarge quantity generator)or(b)#i t am a small quantity generator)Is true.. <br /> 6eneratcx s?DFtehoPs Prinl�& %e A�f WJ 5ignalure a Akindt Day I'l <br /> .,,r 18.tntemabor#ht StapmeMsr�—� � <br /> F lott <br /> ElImpoillo u.S: n Exporthom u.5. Port of entrytexit: <br /> z Transpdrtersi rwture#forexportsanty): Date leawVUS.: <br /> W 17 TransporWAdmwfedgmentof Rec*of MaWiais <br /> Transporter 1 Priniedrl' erne Signature 24 Month ay Yaw <br /> Transporter 2PrintedTjiied Signature Month Day Year <br /> !�'t: ... .....� ..:.. <br /> 18.Discrepancy <br /> 18s.Discrepancy Ind ca(ion Spade 00.. QTM i ,m,:. Partial ReJection fl <br /> FWI Rejia+ziwa <br /> Manifest Retemm Numw <br /> 18h.Alternate Facility(or Generator) U1.EPA ID Nur b <br /> t:9 <br /> Fad;ty's Phone- <br /> 4 <br /> 18c,Signatm OfAitemate lFa<lity for Generator) Month Day Year <br /> a . <br /> z <br /> ra 19.Hazardous Wasta Report Management Method Codes(i.e.,=W for hazardous waste treatment,disposal,and recycling systems) <br /> 1 .444 4!..wp,- 2. H141 T 44�+ <br /> 23.Designated Faaily Qwner or Operator:Certification of receipt of hazardous materials covered by the manifest except ap rated in Item 18a <br /> PrintedlTyp�N Signa + Mnmit y year. <br /> E2Ega4laI43 Reu.a;;tr13)iIrV' i" e..��i,a � DESIGNA? A_1UTY TO EPA's e•MANIFEST SYS EM <br />