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SSL SK SHIP#I 218430888 (I11111111IIIf�"'���I '��'� <br /> 605245347SKS <br /> Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Paget of 3.Emergency Response Phone 4.ManNest Traeldn Number <br /> WASTE MANIFEST CAL000226285 1 1-800-468-1760 0 052 5347 SKS <br /> TI Name and Mailing Address Generators Site Address(d different than mailing address) <br /> "Consolidated Container Co <br /> 75 W Ualpico Rd <br /> TRACY CA 95376-9129 <br /> Generators Phone: 209-836-2151 <br /> 6.Transporter1 Company Name U.S.EPA ID Number <br /> SAFETY—KLEEN SYSTEMS, INC. TXR000081205 <br /> 7.Transporter?Company Name U.S.EPA ID Number <br /> C-11 AU9D&-)007a-3 <br /> B.Designated Facility Nam'and Site Address U.S.EPA ID Number <br /> CLEAN HARBORS ARIZONA, LLC FS <br /> 1340 W LINCOLN ST <br /> PHX , A <br /> Fadl602-258-6155 RZD049318009 <br /> mI's Phone: <br /> 9a. 9b.U.S.DOT Description(Including Proper Shipping Name,Hazard Gass,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> .M g (d <br /> ,.andPaddrGroupany)) No. Type Quantity Wuvw. <br /> TNON RCRA HAZARDOUS WASTE SOLIDS, ( # DM P 223 <br /> ,1t R8 NTS, RAI OIL), N/A <br /> t7 <br /> 4. <br /> 14.Special Harding Instructions and Additional Information TSD:PH 69270710 C099768 CSG: <br /> 24 HR:.> R6ENCY #11p800-468-1760 (SK / TFI) <br /> .. 1s. WAT1ON:I hereby declare that the corMerd's fs ctiricigmr t aFe furry and.. described above by the proper diippi^9 name,and are desaihe4'Vedta9ad. <br /> m denrl and are h all respects in propermaGdm lor transport acooNeg Oo;applicable' national governments regulations.R export shipment and I1Md the Primary <br /> '. <br /> E)"d it 1 5(y that ere rodents of this axrjgo t mdorm to ere Nms of the attudted EPA <br /> I der8fylfratlhewaste mpam®tion statement identified in 40 CFR 26227(a)(d I am a large quantity gengretar) (b)(d a small aerator)is true. <br /> prirrledffyped rtie ` Modh Y <br /> 1b1, 100 <br /> Intorrre6oitel- . . <br /> .F, ❑MnPat to U.S. ❑Export from U.S. Pot of ariayle>ot <br /> Trarepoft signabne(fur exports only): Date leaving U.S.: <br /> W 17.Transporter Arlubwledgmenl of Receipt of Materials <br /> K T .. r 1 PdnteM Name <br /> O1//CCJJ <br /> CL <br /> Q T '-� Narre r� $lyiabneMmtlr Day r <br /> ,- <br /> I 3 <br /> 18.Discrepancy <br /> 18x,Discrepancy Indication Space ❑Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manffest Reference Number. <br /> 18b.Alternate Facility(a Generator) U.S.EPA ID Number <br /> J <br /> U <br /> Fadtl'Js Phase: <br /> w 18c.Signature of Alternate Facility(or Generator) Moth Day Year <br /> Q <br /> z <br /> 19.Hazardous Waste Report Managen�e ,#fe8rod Codes(I.e.,codes fa heraidous waste treabnent,dhposal,:and repYcl�9 systems) <br /> LIJ 1 2. 3.. 4. <br /> 20.De$W;a dfad*,0wner a Operator:Cantiiration of receipt of hazardous materials covered by the marl_t except as nded in Item 18a <br /> PrimedR d��+� J.log✓�Jh.l ' <br /> EPA Form 8700-22(Rev.3-05)Previous editions are obsolete. DESIGNATED FACILITY 7075ESTINATION STATE(IF REQUIRED) <br /> 1)7479378/889842 <br />