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Fro,,. ZMT, Inc. Page: 6/7 Date: 1/4/2012 11:09:00 AM <br /> '1185-01 <br /> PIP so pint cr type.(Form Ceai net far use on elite r12•pilch ( ewrlter,) Farm Aroved.OMS No.2050-0039 <br /> MlID Nb <br /> UNIFORM AZARDQUS -6entraor umer CpL�Q1�JG�JS�Sc� Page 10f 3.Emergency Response PhorC 4,Manlrest Trackirm Numbor <br /> VASTE MANIFEST 1 1-81Zt0-4613-1760 002151714 SKS <br /> SZMnoT1ECHNOLOGII E5drrs Gene afcrS silo Address(it d;ffe sal th sn mailing atdmss) i <br /> 1010 SHAW RD <br /> STOCKTON CA 95215 <br /> ConaraWs PhcrO: 209-547-1965 <br /> vg"!- EM'rtYSTEMS, I U.S.EPA ION'um^er TXR0000509.30 <br /> 7.Transooier2Comparyronrr! 1 <br /> U S.EPA ID Mrrrber <br /> S.Dealgnated Facility Mme and Site Address SAFETY-KLEEN SYSTEMS I NC. U.S._PA IC Ncmher �� <br /> 1722 COOPER CREEK ROAD 00�61g c <br /> 940-483-5200 DENTON, TX 76205 <br /> Facl'ly'a Phone; TXD077603371 <br /> gs 9b.US,OOT CeacrlI(fnc!edlnq PrcperSWpping Name,Hazard V'Iss,ID Number, 10,Ctotainor5 r <br /> HM and Puking Gnup(If nay)) 11. otet Q.Unit <br /> No. Type Quantity WI Nof 13.VJ;rte ccdc:t <br /> X 1RQ WASTE FLAMMABLE LIQUIDS, N.O.S. DM P D®01 214 DI.IT; <br /> o (P—CHLOROSENZOTRIFLUORIDE) <br /> 3 UN1993 PG III (D001) (� <br /> Lu z. <br /> c� <br /> 3. <br /> 4 <br /> c,gperiei'ands^g!nslur,9nnsan,7ACtlllirrdllr`ama`- K TRCK#1109211 0003142935 <br /> 1)ERG#128 _._�� .�_ <br /> SK AUTH'D TO USE SUBSEQUENT CARRIERS; 41036 67585 81681 82738 85:399 <br /> 15. GENERATOR'S;OFFEROR1CERTIFICATION:Ihorehy declare hat thoconlentaoflhlsro^clnnnnntamrrpvard.ec ml^4p4n^rtbadxfi7yrpvitrpropaikvp�(ng'name,andnmclas9lfad,pao'<agad, <br /> - <br /> arkedandatelac,placarded,and are orlainallrtwrimtsnproper condition for IransporlAccordingtoapplicable intema;lonalandn2l!onalgcvernmertitragutelfonr.IIsxpvlshbTRnland am the?rotary <br /> Cxpr,I caftfh/that the contents a'ftconsignman'conform 1011+0*ms of'nR anat9ad EPAAcknowiedgmert ff Ccnaw. <br /> i ceNfy Iha'Iho waste minlmaatlrn cta,ement identlNed!n 40 CF4 262.27(x)(f I em a terga qu:tnllry generator cr(b)(Y a all quanfaygerleramq!s We. <br /> Gen_ 's .eitt5 Pd^lOdrTyprtl None slAnalu /' MpJ1tf1 Day Yaer <br /> J le.InlnmotlJncN:hipttttfnis � I f U I <br /> Z ❑Import to U.S• ❑Exmrt from U.S, Port of entry/oxg; <br /> Trwnaorin,rIZ.,kxr(fa ex arta only): <br /> Que leedrq 1)., <br /> a 17.TrnnspodRrAcknoWsegmsnl of Remit of�,'atenals <br /> aTransporler 1 PnnWiTyped Nara /�1 /1 3!nail ro <br /> —�,, Month osy Year <br /> 'rram0 itY 2 PFnitd TyptC NCmO sgnaluro <br /> Nonih Oiy Yoar <br /> 10.Discropxrxry �*i <br /> tan.O!scropancy Iralwlion$pact <br /> 1� ounitiy ❑Typo ❑Raalduo L^I Pnrfial Re(erlian <br /> ❑Full Refection <br /> Macdeet Rofarena, <br /> 194,AllemaM FaatNumber.ily(or Gcaeralcv) U.S.EPA ID h11M11ber <br /> J <br /> FPO Vq Rom f <br /> U <br /> 180.Signature ofAllsma'e FscNty(cr Gnnemetol <br /> Q NOnlh Day yAnr <br /> 14.Mnzxmoue Westo Report k4?nPpsmenl Metned C0d56(1 00005 rtr haxa-dcus w;yoto Iroalmenl.4lspoaal,and raCyCNgg oyal9ms) <br /> LM <br /> 4. <br /> 20.Delgneled F,xiNy Ownpr or Cporalor:CRnlac,llrn of rarelpt of 07ardOtle matelot;covered by the Manifest except as ri'm In Item 188 <br /> f dn'ed!sped 1011e Signature <br /> ppggrr����77 rdanlh coy plat <br /> )A@rgQ2 (R}'3-05) Prevlovs ad3ong are obsolete. q.S �1 <br /> 1)24468!29/40349840 <br /> 4) DESIGNATED FACILITY TO DEST NATION STATE(IF REQUIRED) <br /> This fax was received by GFI FAXmaker fax server <br />