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Y\204244 - 155INA MAT BILL OF 1.dfferors @Number ge 1 of 3,Emergency Reaponse Phone 14,.Tracking Number <br /> UWMIMAINFIESY t _ <br /> 5.OfFeroes.Name and WUM Address Oh-es SteAddrasa(ff different than mailing address) <br /> TIN, INC. (020—TRACY) / DAN PEREZ TIN, INC (#020—TRACY) / LEAN PEREZ <br /> 400 WEST VALPICO ROAD—SITE 400 WEST VALPICO ROAD—SITE <br /> TRACY, CA 95376 TRACY CA 95376 <br /> Offerora Phoria: (209)836-1971 GEN: 314495 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> I <br /> 7.Transporter 2 Company Nerne U.S.EPA ID Number <br /> 8.Designated Facility Name and Site Address U.S.EPA ID Number <br /> HERITAGE ENVIRONMENTAL SERVICES LLC <br /> 284 E STOREY RD AZD081705402 <br /> COOL I EDGE, AZ 852228 <br /> Fact Phone: <br /> ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit <br /> HM and Peddng Group(ti WA No. Type Quantity INt.Nol. <br /> 1. <br /> I <br /> (U _ = 4 a3 V <br /> 2. <br /> x , <br /> .41;, , , <br /> 3. <br /> NON—DOT UNIVERSAL WASTE-MERCURY CONTAINING LAMPS 1 2-0 D s <br /> 4. r <br /> NON—DOT UNIVERSAL WASTE-MERCURY CONTAINING LAMPS <br /> p T <br /> 5. <br /> NON—DOTfNON—RCRA REGULATED 3�f <br /> 8. <br /> 7. <br /> 13.Special Handling Instructions and Additional Infarmalfon <br /> 1.W14 [275945 2.W15_0532319 3.W16 0532317 4.W17 0532378 5.W19 0259558 <br /> cr-x e P7- <br /> i.7qAF10.91 <br /> 14, OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment arefully and aceUralely described above by the proper shipping name,and are classified,packaged, <br /> marked and labetedfplacarded,and are in ail respects in proper condition for transport according m eppfic"Inlegillono and nailonai govern regulations. <br /> Offerors Prinlwiffyj N Signature Month Day Year <br /> T z <br /> 15.T ,pAAdnowtAment of Receipt of Male //� <br /> Tran rter ntgElTYPed Na Month dray !V . <br /> w year <br /> Transporter 2 Prbrtedffyped Name F Svalure Month Day year <br /> t <br /> { . 16.Discrepancy <br /> 17.Designated Facility Owner or Operator:Certification of receipt of hazardous Bill of LadingA4anffest covered by the manifest except as noted in item 16 <br /> tA PdntedlTyped Name Signature Month Day Year <br /> ^ DESIGNATED FACILIiYTO OFFEROR ` <br />