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BILL 4F LADING 1 Customer <br /> US ERA ID No. Document <br /> si 2.Page i <br /> oarmern No. <br /> of 1 <br /> 3.Generator's Name aid Mailing Address <br /> TRACY DODGE CHRYSLER <br /> 3460 NAGLEE ROAD BUNDLED SERVICE <br /> 4.GTMq1y Phone 4 209$20-1800 CA 95376 <br /> 5.Transporter 1 Company Nemo 8. US EPA ID Number A.State Transporter's ID <br /> ASBURY ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 S.Transporter 1 Phone _ <br /> 7.Transporter 2 Company Name 8. US EPA 10 Number <br /> O.Slate Transporter'9 ID <br /> D.TVensperter 2Phone <br /> 9.Designated Facility Name and Site Address 10. US EPA ID Number E.State Facility`s ID <br /> CLEAN HARBORS-WILMINGTON <br /> 1737 DENNI STREET <br /> F Facilityrs Phone <br /> WILMINGTON CA 90744 C AD 0 4 4 4 2 9 8 3 5 (310)835-0775 <br /> 11.WASTE DESCRIPTION 12.Containers 13. 14. <br /> No. TypeTom Unit <br /> a. <br /> Quamity Wt.AIOI, <br /> AEROSOLS,2.1, UN 1950'UNIVERSAL WASTE' D M P <br /> b. <br /> C. <br /> g <br /> LL G.Additional Descriptions for Materials Listed Above H.Handling Codes for Wastes Listed Above <br /> J <br /> 15.Special Handling Instructions and Additional Information <br /> EMERGENCY CONTACT:CHEMTREC 1-800-4249300*PROFILE#981 :TRA076-CH1471717 AEROSOLS"PO#A110099914 <br /> APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT <br /> SITE: 1 <br /> l: <br /> 16.GENERAT'OR'S CERTIFICATION:I hereby certify that the contents of this shipment are fully and accurately described and are In all respects <br /> in proper condition for transport.The materials described on this manifest are not subject to federal hazardous waste regulations. <br /> Data <br /> PrintedlTyped N2&ULK7b <br /> (� Signature Month Day Year <br /> �17�t, <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> P Date <br /> A PrintedfTyped Nam Signatur Month Day Year <br /> N <br /> S <br /> P <br /> O 18.Transport 2 Acknewledgemerrt of Rece pt of Materials <br /> Date <br /> R Printed(fyped Name Signature Month Day Year <br /> E' <br /> R <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> L20.Facility Owner or Operator;Certification of receipt of the waste materials covered by this manifest,except as noted in item 19. <br /> Date <br /> T Printed/Typed Name- Signature � Month 47 ,Year <br /> Y f Com' ec J�,- eti <br />