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SSL SK SHIP# 227550567 <br /> Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator 10 Number ? 2.Page 1 of 3.EEme��ppW�p�y RQQ gp�gp,!P}%g 4.Manifest Tracking Number <br /> WASTE MANIFEST CA1_00t&iB39.,6 1 1—tlf�0-4btl-1/bol 006952802 SKS <br /> 5.Generators Name and Mailing Address Generator's Site Address(if different than mailing address) - <br /> JB Hunt — Stoca <br /> 2660 Loomis Rd <br /> STOCKTON CA 95205-0000 <br /> Generators Phone: 209'-'235-1365 <br /> s.rrygppdA 1LnmpanyNaoe SYSTEMS INC U.S.EPA ID Number TXR600081205 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> CLEAN HARBORS ENVIRONMENTAL SVC INC. MAD039322250 <br /> 8,Designated Facility Name and Site Address CLEAN HARBORS SAN JOSE U.S.EPA ID Number <br /> 1021 BERRYESSA ROAD <br /> SAN JOSE , CA 95133 <br /> CAD®59434310 <br /> 408-441-0962 <br /> Facility's Phone: <br /> gra 91b.U.S.DOT Description(inducing Proper Shipping Name,Heard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity Wt.Nol. <br /> 1. NONE NON RCRA HAZARDOUS WP._ DM �S'0 P 352 <br /> I, (ABMRBENTS CONTAMINATED WITH '01t_), NiA <br /> Z z. NON—RCRA HAZARDOUS WASTE, SOLI DM �t7 P 223 <br /> (OIL FILTERS) —4 <br /> 3. <br /> 4. <br /> 14.Special Handling Instructions and Additional Information TSD.S,) 79000100 JB9793 CSS S <br /> 24H EMERSENCY#800-468--t764d--Cu/SK/TFI—Contract retained by generator conFer•s a ency authori y <br /> initialon tloef. <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: Ihereby declare that the contents of this consignment am fully and accurately described above by the propershipping name,and are classified,packaged, <br /> marked and labeled/placarded,and am in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. <br /> I certify,that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity general r)is true. <br /> GenwatorslOfferors Printed/Typed Name. Signature i Month DayYear <br /> '._ !,, . ' —`fix/� / C JS+ <br /> 16.International Shipments I Im ort to U.S. ' <br /> f ❑ p ❑Export from U.S. Port of entry/exit: <br /> ? Transporter signature(for exports only): Date leaving U.S.. <br /> W 17.Transporter Acknowledgment of Receipt of Materials <br /> K Tr iter i Pnnted/Typed Nae SignatuMonth Day Year <br /> Z Transporter 2 PnntedrFyped Name Signaftfre V M nth Day Year <br /> F <br /> I18.Discrepancy <br /> 18a.Discrepancy Indioafion Space <br /> ElQuantity El Type Residue PaNal Rejection Full Rejection <br /> Manifest Reference Number: <br /> 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> J <br /> U <br /> LL Facility's Phone: <br /> w Ise.Signature of Alternate Facility(or Generator) Month Day Year <br /> a <br /> Z <br /> LD <br /> 19.Hazardous Waste Report Management Method Codes lie.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> G 1. 2. 3. 4. <br /> 20.Designated Facility Owner or Operator:Certification or receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> Printed/Typed Name Signature Month Day Year <br /> EPA Form 8700-22(Rev.12-17 Previous editions are obsolete. GENERATOR'S INITIAL COPY <br /> 1)769024i/110 251 2)7612003/156777 <br />