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07/13/2011 06:29 2095453 SAFETY KLEEN • PAGE 04/08 <br /> 7-Ids-01 . <br /> Plasae print or type.(Form designod lar use on allle(12• Iloh l writer. Form Approved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS 1.Cenamfd•ID Number 2.Page 1 of 3.Emergency Reeponas Pltonp a,ManlleslTnckkrg Num nr <br /> WASTE MANIFEST . 1001983486 SKS <br /> a mSi9@11�3NIW8k7274uIrRgdgece OenerohgNaI14I'eClts+l(1P74reR@DTOFKO�'eWRRMS <br /> PO BOX 201010 1533 E LINDSAY ST <br /> STOCKTON CR 95201 ATTN TRANSIT DISTRICT <br /> 209-948-5566 STOCKTON CA 95205 <br /> Cemrabr'e Dlmne; ' <br /> 8. Co t a , U.S.EPAID NImner d <br /> 7.Transporter 2 Ccmpau bAma. <br /> d� ,� U.B.EPA IO Numhcr <br /> 'ra^^s -1-1r- p� R�a5 e�791 <br /> s.Dnlpnnred Fndllly Namc arta Silo address 1722 COOPER CR$EK RD'RD 'J,S,ER11D Numher <br /> 940-483-5200 TXD077603371 <br /> Faclsi'R Phone, <br /> 91).U.S.DOTD0mn01ion(induding Proper Shbelna Name.Hazard tase,IDNumbor, 10.Contrenor, 11.Twel 1)..Unil 13,Was19COdee. . . <br /> H and Plchag Giouptll inv)) No., o Daanthy WI.Noi. <br /> m Un, IQ <br /> LIQUID,—N.O.S. (GASOLINE, BENZENE) 4. 1 <br /> UN3175 PG II Z -#09• <br /> w 2' (D@01) ' <br /> FLAWIABtE e. t UN 9500 BM P DW BIDS! bm <br /> Ag --D@ —ObTS <br /> 3 41F! <br /> W 801 <br /> �•-t�Pl?795�8--��I—FB002)- •^ <br /> WASTE SOHO <br /> 000037 <br /> r <br /> n' (RE50RDENT AND OIL) � 3101 <br /> ,ss�taeIy�a�y1I <br /> 1a.1gtH5ip1�3�t, n s. r n�`��Gpl� <br /> 24 HR EMERGENCY 800-468-1760(SAFETY-KLEEN - 94138) <br /> SI( RUTH'D TO USE SUBSEGtUENT CARRIERS. 41038, 87565, 81.681, 82739, 85399 <br /> 15, 3ENERATORr9YOFFC11011'5 CERTIFICATION: I hefedy decalro that Iho conferees Arms conspnmonl we fully and accurately deacdbed Dboveby the proparehlpping name,aid ars cbsslled,Packaged, <br /> marked and laboledfdacardeC and are In an resppGU In proper part for Irenspon according to npplutio Intamelronel and nslWnel lovernmantal regulations.If espoe thlpmenf end I0m m0 Pdmery <br /> Esnnrton l tariff that the contemn of Ht ennelpnmem conform to the termed the almolled EPAAcImowladgment of Consent. <br /> I eedify that the waste min4Nzelbn statement 101,111W In 40 CFR 282?.1(a)(If Ioro ANrge quanmy genemPor)or(b)(III am a small quantity generrAm IS Iruo. <br /> Generalar'910nerafn Printe#R Dad Nemo ^ 3lgnetum Month Day Yo <br /> J 15.IPOrnalanN SH emir — -' <br /> IrIport IC us ❑ExPWAIII US. port At'naylokll: <br /> Transporter elgnown,(for oypons only(: 0110leaving U.S.: <br /> W 17.TIa ' Acknowimparent Of R9talPl of Meierhl, <br /> Tm p r famalrypndNoneBlum Mamh ay Y <br /> N <br /> r, dlpr2 yped areaofin D r <br /> 1a.Discrepancy <br /> 180,Discrepancy Indication space JC1uaNll l a Rosldtis '6dbn P101I RP <br /> Y ❑ YP 1: f El Full Rapdian <br /> Manifest Reforonco Numbea <br /> IAk Alternate Facility(or Aonamim) U.S.EPA ID Numbee <br /> 7 <br /> v I <br /> m Fndlltys Phone: <br /> 18c.SIAm110m WAllernate FAvIty lar enaralatf Month Day Yam <br /> 4 <br /> z <br /> h 19.Hazardous Wd5la Report Manrlgemenl Method Cade,(1.0.,w0cs for hazardous waste lrealmonl.disposal,and recycling system,) <br /> 2. <br /> '20-,Dae n FseallyOwner or CDsrol&.gedlPeillSn offaoNT(naTeMouf msleii3ls wvered'by laze 1rr7076A escap �tlad ln'll 77e <br /> Print pest Nemo signal nth Day Ye <br /> — — .-._ _— e� — <br /> —-- — - <br /> _.,.__E&910t72 �g2;(. ICppe. -47 @187,68'4 DESIGNAT61i CI41 Y-TO-DESTINATIONST0.TE(IF_REOUIRED)—i.. <br /> 1)20@0fi9847/401074@ a - ^d"" s�z/a 4TE00110540/40167801 <br />