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BILL OF LADING/MANIFEST -Shippefs US EPA ID No.(If Applicable) Document 2,pprage l/�rr. <br /> Shippers <br /> US EP rI No in : G meat . Ir - fir' <br /> 3.Shipper's Name and Mailing Address i' CLANr FOODS �� � - 1 � It .W V,, <br /> 800 EAST PESCADERO DR .._._ <br /> TRAP--:Y CA 95304 ilur 1 Zulu <br /> 4.Shipper's Phone( i?,09 ),-21-7514 <br /> 5.Transporter 1 Company Name6, US EPA ID Number ,t:Frar�t HMTH <br /> L '"7,1 r 0 q-�=r5.�r31TA <br /> ... - _. .. <br /> 7.Transporter 2 Company Name 8. US EPA ID Number B.Trensporter's Phone <br /> 9.Designated Facility Name and Site Address 7F-2.1 10. US EPA ID Number C.Facility's Phone <br /> r,3faf=E TY Ki_C:t=N i:3Yr TE_M%iT INC. <br /> 6000 A8TH STREET <br /> SACRAMENTO Cts 95828 CAJ?K1 1-()84517 9.16--366-4913 <br /> 11.Shipping Name and Description 12.Con j iners 13. 14 <br /> To al Unit <br /> HM No. Type Quantity WUVol <br /> a. .)PAINED USED OIL. FILTcRS <br /> I DM P <br /> b. <br /> S <br /> H <br /> I c. <br /> P <br /> P <br /> E <br /> R d <br /> T1 <br /> 15.Special Handling Instruction and Additional Information /- <br /> SK ?SHIPit 2212346541 3274117 <br /> 24 HR EMERGENCY #1—E2112)-468-J 760 (SAFETY—KLEEN — 94138 <br /> A) NONE <br /> SK AUTHORIZED TO RETAIN LICENSED SUBSEQUENT CARRIERS AS NECESSARY <br /> A <br /> DOT/PRF!-. A. 14476/150167 B C. D. <br /> 16a.US DOT HAZARDOUS MATERIALS SHIPPER'S CERTIFICATION: •rhisiswoemrymauh..Woa-named malanals are prepany dimadee.detorted,paelm ad,manes and labeled,and are In pmpar <br /> modimn for inamon,tanon acmd[no to the appificabhe re mauone of Da dela or Trent onadon. <br /> Printed/Typed Name OW I <br /> Month Day Year <br /> N <br /> 16b.NON-REGULATED SHIPPER'S CERTIFICATION: I certify the materials described above on this form are not subject to federal regulations for Transportation or Disposal <br /> a Print �ffypad Name <br /> �'� t _ MOMM1 OaY veer <br /> T <br /> R 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> N Prin/t�edh/]'yped Name / Signature �" Month Day Year <br /> s 7255 �//l G l�/v -/lam C/I!L� �� � ?'i Ir,) <br /> P <br /> -e� 18.Transporter 2 Acknowledgement of Receipt of Materials <br /> Red <br /> T- Pnntedfl YP Name Signature Month Day Year <br /> E <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L 20.Facility Owner or Operator.Certification of receipt of materials covered by this form except as noted in Item 19. <br /> 1 <br /> T <br /> V Pdntedi Typed Name Signature Month Day Year <br /> GENERATOR'S COPY FORM NO.01-90291(11/09) <br />