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07/13/2011 06:29 2095453 SAFETY KLEEN • PAGE 03/08 <br /> :-185-01 <br /> Please print or pipe,(Form deWpnotl for o6B do 6110 12-pitch)typeWlitey Form mvod,OMB N0.20500D3 <br /> UNIFORAIIIAZARDOUS 1.DooemmrlD Number 7.Pape l of 3,Emergency Response Phone 566791910 <br /> Al T7Xmg N91 <br /> WASTE MANIFEST cA09e167s093 _ 0-a - 0 0 0 8 9 51 O 3 SKS <br /> 5.Garr Ors Nome and Mall r ilAddmes Gemrafore SO Address Of offemnt Ilan mAhlnp oddmlal <br /> SAN JOAQUIN REGIONAL TRANSIT DISTRICT <br /> 1533 E LINDSAY ST ATTN TRANSIT DISTRE <br /> S,TOCKTON CA 93205 <br /> Op a or Phone: 209-949-3566 <br /> B.Tdne nniPrl comp an Nome U.S.EPA ID Number <br /> SAP�ETY-KLES SYSTEMSs INC. TXR000030930 <br /> T.ponsponef 2 Conpmy Nome .Yew a U.S.EPA ID Nmnbar <br /> 6.0811PABMdFAapryName and$110Addmoa SAFETY—KLEEN S.YMMS, INC. 000760 US.EPA ID Number <br /> 6000 BETH STREET <br /> A <br /> 916-386—4913SACRAMENTO CA 95828 <br /> . fedlr-0�; . . CA0000684517 <br /> 6X'- .elsU.S.OOT Des6lpdmr{Including Proper Shipping Nemo,Hazard Clop,ID NNeber, Ip.CoMAInBIs 11.1bIN 72AN1 <br /> HM And Pa(Aing Group Of apy)) 13.Weare Cadee <br /> ���� No. Type D.A6M Wtledl. <br /> 1 f A0UE011S .PARTT& YA8HERSSOLUT I�O1N)0 OM S 13� <br /> 2- <br /> =1 L <br /> 2. <br /> 9. <br /> 4 <br /> 1A SpodM Hs urs►•inxmwomendnauuloralfmameuan SK TRCN0II.0269440 4038334761 0000371161 0907,24 <br /> 14...GENERATOR'BIDFFEROR'SCERTIFICAtIOH: I hnmby dpdme lied IM.ntut,o(this o 99maenlaA fMly oho sokatalyeewlbed nbMm by the prepm Mpping name.BN ere dpaInIO&"pd. <br /> matkBd and labolod/plerofped,and em In All m:peds in proper condition foMnspor 1=,dMp 00.a0lpNA mlefnebpNl and mreonal goymomeMel mg W Bone.if export shlpman(pnd l am Xte PA6rmy <br /> EApodm 16U;4y apt lho con(pnis of life cor lominnl rmrtemt to plb lama otlhglon inpd EPA'hIft"dpmenl of CanapAl:. <br /> tm6MyN611P/W01b M1AImU,g116n'e1eNPoAM MOM1god Ip ID CFR162,P7(AI I1IOpIa I7gI W0nbly pAnBmloQ <br /> at oil omeLna111LgwlI q rl mfe. <br /> GeIaXAImNO rpyjn Prpted NemA� :-� Spot m Month Year <br /> �ImpodbU.9.' QExpon from U.6.-- PodWNAryNMI: � <br /> � 'TdnsyaMhbAAtum ferekpbasoWY). — Daglwiq U.S.. <br /> .D.e 17 TMOorAdomdodgmeilofReaap7 ofMAbAe6 ,' . • _ <br /> pd TrenspeMr,1 FrYDud Ndme Signature <br /> Abn+h Day Year <br /> .: .TruoWd4P,.Mparfypeci Name, s <br /> Memh goy ram <br /> cz <br /> tees pe"'" y14.4vbh SPA.- a.n1Xy ' dTyPe ❑RaAldrm 0padlal RAledl. ❑FaaRelddlen . <br /> tae AXemmA FAdlpy(O"Aslaled M a! tArrbben <br /> U.B.EPA ID Num6or <br /> e Foolwa Phones. <br /> F tees Bigrmlum olAlemob FepIIIN(m Onnnmleq- - Monin Dey Yom <br /> ,,.� qA Ha3Mda"iCWep6;Ae2al1 XeplM1raA1Ms71a0Coeel l(i:rryleX lEf11XRMdlp vrYafa MM)11enG dltCadp,And , Byafm.) <br /> PO DedlymandFAsMy Oxrrmer DpMAAYt>mRdaanofnasmrplefAomeWomNAAnM(OsaroO by tlro pxnlNslW.pin Inlbmt6o <br /> a so nmum <br /> PM 17 <br /> EPA'F 22( GY.& ProvioUs Uoruspmobsoats. ESI AT FA ILITYTOGENERATORSTATEOFREQUIR D) <br /> 1)0014941 ,2) 3). 4) <br />