Laserfiche WebLink
TEXAS NATURAL RESOURCE <br />CCNSERVATION COMMISSION 7 - 1, O 1 ' <br />P.O. Box 13087 <br />Austin, Texas 78711-3087 <br />DI.— -- — t„na , P— rives. A f— „co nn ofit, 117- f,hl hmawrifor 1 <br />E O,pT <br />s � a <br />r � <br />Fnrrn annmved. OMB No. 2050-0039. <br />TNRCC-0311 (Rev. 07/011971• Wnite - original N1nK- 1 Ju r-acuny r Cuuw- i ransporner vreen-lJenC dIVI D DI -Py <br />.r{; s )r;t.•, F• )4',o0203933u <br />UNIFORM HAZARDOUS <br />1. Generator's US EPA ID No. Manifest 2. Page 1 <br />Information in the shaded areas <br />WASTE MANIFEST <br />-. —n,; „ ;, , �ument No. of 0 <br />is not required by Federal law. <br />3. Generator's Name and Mailing Address MC -TOR GUARD CORP te• anifest Document Number <br />580 CAR.NEGIE ST. +. r, ,5 0928348 <br />MAI ITECA CA 95337-6141 = ;Stxe��e�nerator' <br />4. Generator's Phone ( 2 0 9 ) 2 3 9 — 9 19 1 - QV{t5 <br />5. Transporter 1 Company Name 6. US EPA ID Number Mate; �dnsporter's (D`` Ufa . <br />t porter' Phone ` 0 = 5 i$ 0 <br />7. Transporter 2 Company Name 8. US EPA ID Number <br />' n' errs Phone <br />9. Designated Facility Name and Site Address 000618 10. US EPA ID Number _ SCiI. 1` - <br />��si : � <br />SAFE ?'Y-KLE£Id SYSTEMS, INC. =. ;, <br />1'722 COOPER CREEK ROAD U shone- <br />DEINT017, TX 762080042 <br />3— ` �. <br />11A. <br />11. US DOT Description (including Proper Shipping Name, Hazard Class, ID 12. Containers <br />P ( 9 P PP 9 V <br />13. <br />' Total <br />14.N <br />No <br />UnitHM <br />Number and Packing Group) No•TypeQuantity <br />Wt/Volto <br />-A <br />a.c <br />`r'"1 <br />G <br />WASTE OIL AND ABSORBENT MIXTURE* `c, <br />(NOT USDOT HAZARDOUS MATERIAL) I <br />T S <br />y 6 <br />N <br />E <br />R <br />b. <br />• ` - <br />"" `�''� <br />NON RCRA HAZiiRDOUS--WASTE;—SOLI Jr <br />_-- <br />T <br />( OII,, ABS 0R BE NT) --- <br />R <br />C. <br />u � <br />d. <br />�+x? <br />Pr,- Pay <br />c+ti M <br />v <br />x. andli Codes foUsted ve <br />J. Additional Descriptions for Materials Listed Above � 't " r Wastes <br />IA) N014E 4891 <br />15. Special Handling Instructions and Additional Information�' •'M!'ST R/T 103982198 0000-3701-64 <br />GENERATOR. <br />EMERGE14CY RESP 800-468-1760(24 HR). IF UNDELIVER18LE RETURN TO <br />SK CORP AUTH"D TO USE SUBSEQUENT CARRIERS: 81300,40355 41015,40582,84815 <br />I�VDQT& A- <br />16. GENERATOR's CERTIFICATION: I hereby derlare that the contents of this consignment are fully and accurately described above by the proper shipping name and are <br />classified, packed, marked, and labelled/placarded, and are in all respects in proper condition for transport by highway according to applicable international and national <br />government regulations, including applicable state regulations. <br />If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br />economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and <br />future threat to human health and the environment, OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select <br />the best waste management method that is available to me and that I can afford. <br />t� <br />Printed/Typed Name <br />Signature Month Day, Year <br />r 7 <br />r y; • <br />T <br />17. Transporter 1 Acknowledgement of Receipt of Materials Date <br />A <br />Printed/Typed Name Signature ,, a Month Day Year <br />j <br />5 <br />l <br />R <br />0 <br />18. Transporter 2 Acknowledgement of Receipt of Materials Date <br />R <br />Printed/Typed Name <br />Signature Month Day Year <br />E <br />R <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />I <br />L <br />20. Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. <br />T <br />Y <br />Date <br />Printed/Typed Name <br />Signature Month Day Year <br />TNRCC-0311 (Rev. 07/011971• Wnite - original N1nK- 1 Ju r-acuny r Cuuw- i ransporner vreen-lJenC dIVI D DI -Py <br />.r{; s )r;t.•, F• )4',o0203933u <br />