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SHIPPING PAPEIS <br />Paee l <br />Shipper Name & Address: <br />Carrier: <br />MSE Environmental, Inc. <br />1250-H Avenida Acaso, Camarillo, CA 93012 <br />(805)987-0217 <br />CAD982504953 <br />NOTE: These materials are are RCRA exempt Household Hazardous Wastes (HHW) being transported under attached <br />DTSC variance # to the below designated temporary H1 -IW collection location for consolidation and <br />transportation to a "Final Disposal Facility" (RCRA TSDF). <br />Destination (Consignee): <br />24 Hour Emergency Information: <br />Frank Doerfler, Jr. (800) 350-0217 <br />5 gal <br />30 gal <br />55 gal <br />55 gal <br />Yard <br />Total <br />HM <br />Proper Shipping Names <br />DF <br />DF <br />DF <br />DM <br />Box <br />Other <br />Quantity <br />CF <br />(lbs) <br />Non-RCRA Hazardous Waste Liquid <br />(Motor Oil) <br />Non-RCRA Hazardous Waste Liquid <br />(Antifreeze) <br />Flammable Liquids, n.o.s., 3, UN1993, II <br />(Petroleum Distillates, Alcohol) <br />ERG #: 128 <br />Flammable Solid, Organic, n.o.s., 4.1, <br />UN1325, H (Petroleum Distilates, Alcohol) <br />ERG #: 133 <br />Pesticides, Liquid, Flammable, Toxic, n.o.s. <br />6. 1, UN3021, II (Petroleum Distillates, <br />Chlordane) ERG #: 131 <br />Pesticides, Solid, Toxic, n.o.s., 6.1, <br />UN2588, H (Chlordane, DDT) <br />ERG #: 151 <br />Corrosive Liquid, n.o.s., 8, UN1760, II <br />(Sulfuric Acid, Hydrochloric Acid) <br />ERG #: 154 <br />Caustic Alkali Liquid, n.o.s., *, UN1719, II <br />(Sodium Hydroxide, Ammonia) <br />ERG #: 154 <br />CERTIFICATION: This is to certify that the above-named materials are properly classified, described, packaged, marked and <br />labeled, and are in proper condition for transportation according to the applicable regulations of the Department of Transportation. <br />Shipper / Print Name: Signature: Date: <br />Carrier / Print Name: <br />Signature: <br />Date: <br />Destination / Print Name: <br />Signature: <br />Date: <br />