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CSG SK-SSL-BOX-21 Brandon J Gaither 11/19/19 12:05 PAGE 2 <br /> SHIPPING DOCUMENT <br /> IN THE EVENT OF AN EMERGENCY CALL **24-Hr-Number** 1-800-468-1760(Safety-Kleen) <br /> REFERENCE NBR. <br /> CUSTOMER#/GENERATOR: BR26816 Brocchini Farms Inc 81568215-1905903133 <br /> 27011 S Austin Rd <br /> Ripon CA 95366-9625 <br /> PHONE 209-599-4229 <br /> GENERATOR USEPA ID. CAL000234562 GENERATOR STATE <br /> MANIFEST#: 007312173SKS FORM CD: 1D SHIP# 229901832 <br /> TRANSPORTER 1 TXR000081205 Safety Kleen <br /> 5050 SALIDA BLVD <br /> SALIDA,CA. 95368 <br /> TNSP PHONE: 209-545-1011 <br /> TRANSPORTER 2 <br /> US DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID) <br /> NON-RCRA HAZARDOUS WASTE, LIQUID <br /> (AQUEOUS PARTS WASHER SOLUTION) <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 134 <br /> TOTAL CONT 1 TYPE DM WT/VOL G SKDOT 14941 <br /> CNT#: 191114991962 SZ: 30 GAL/114 L CONTAINERS QTY: 20 PROF# 156023 CA CAT CODE:G <br /> DESIGNATED FACILITY NAME/ADDRESS: <br /> SAFETY-KLEEN SYSTEMS, INC. <br /> 6000 88TH STREET <br /> SACRAMENTO CA 95828 <br /> TSD PHONE: 916-386-4913 <br /> FACILITY USEPA ID NO CA0000084517 <br /> FACILITY STATE ID NO <br /> GENERATOR STATUS <br /> 220-2200 lbs/month <br /> Signature <br /> CUSTOMER / GENERATOR: jacob lopez <br />