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ipper's US EPA ID No. (If Applicable) KDocu �Npage 1 <br />BILL OF LADINGWANIFEST7 <br />of CAD98-1964489 <br />3. Shipper's Name and Mailing Address DART–CONTAINER <br />1400 VICTOR RD <br />F1 <br />_1 1 <br />15. Special Handling Instruction and Additional information <br />LODI <br />CA 95240 <br />SK CORP ACJ'1sH'D TO USE SUBSEQUENT CARRIERS- 40343, 41,03 ,X31 , 82 39, 86256 <br />4. Shipper's Phone 2C.9)333-808 <br />SRDOT# A> 161.7 5. 1617 C,.: i.) ; <br />16a. US DOT HAZARDOUS MATERIALS SHIPPER'S CERTIFICATION: "rhes la to oertrry that the above-named materials aro Property o oftheed. described, packaged, s marked and labeled and aro in proper <br />condition for trare iia+ accordi to thea licabla ulations of the De ertment of Trans ortation. <br />Printed/Typed Name Month <br />5. Transporter 1 Company Name 6. <br />US EPA ID Number <br />A. Transporter's Phone <br />16b. NON-REGULATED SHIPPER'S CERTIFICATION: I certify the materials described above on this form are not subject to federal regulations for Transportation or Disposal. <br />Printed/Typed Name Month <br />Day Year <br />T 17. Transporter 1 Acknowledgement of Receipt of Materials <br />R <br />A Printed/Typed Name <br />7. Transporter 2 Company Name 8. <br />US EPA ID Number <br />B. Transporter's Phone <br />1 <br />777 <br />P <br />O 18. 'transporter 2 Acknowledgement of R&eipt of Materials <br />9. Designated Facility Name and Site Address 000618 10. <br />US EPA ID Number <br />C. Facility's Phone <br />E <br />R <br />AF T -- LEEN SYSTEMS, INC. <br />19. Discrepancy Indication Space <br />F <br />A <br />17COOPER CREEK OAD <br />DENTON, T "1762080776033'71 <br />C <br />40 483-5200 <br />1 <br />L 20. Facility Owner or Operator. Certification of receipt of materials covered by this form except as noted in Item 19. <br />1 <br />11. Shipping Name and Description <br />Day Year <br />12. Containers <br />13. <br />Total <br />14 <br />Unit <br />F—H—M-1 <br />No. <br />Type <br />Quantity <br />Wwol <br />a. <br />RESIDUEi LAST CONTAINED,— AIN <br />b. <br />RESIDUE. LAS'S CONTAINED <br />rod <br />m.. <br />d } t +�'! �?.s rt �,,,. 8 <br />H <br />c. <br />P <br />P <br />E <br />F1 <br />_1 1 <br />15. Special Handling Instruction and Additional information <br />GENERATOR'S COPY FORM NO. 90291 (11/96) <br />EMERGENCY RESP00--_46 3-�1.160(2). A ON 1 ON <br />SK CORP ACJ'1sH'D TO USE SUBSEQUENT CARRIERS- 40343, 41,03 ,X31 , 82 39, 86256 <br />SRDOT# A> 161.7 5. 1617 C,.: i.) ; <br />16a. US DOT HAZARDOUS MATERIALS SHIPPER'S CERTIFICATION: "rhes la to oertrry that the above-named materials aro Property o oftheed. described, packaged, s marked and labeled and aro in proper <br />condition for trare iia+ accordi to thea licabla ulations of the De ertment of Trans ortation. <br />Printed/Typed Name Month <br />Day Year <br />me <br />16b. NON-REGULATED SHIPPER'S CERTIFICATION: I certify the materials described above on this form are not subject to federal regulations for Transportation or Disposal. <br />Printed/Typed Name Month <br />Day Year <br />T 17. Transporter 1 Acknowledgement of Receipt of Materials <br />R <br />A Printed/Typed Name <br />Signature Month <br />Day Year <br />N <br />1 <br />777 <br />P <br />O 18. 'transporter 2 Acknowledgement of R&eipt of Materials <br />R Printed/Typed Name Signature Month <br />T <br />Day Year <br />E <br />R <br />19. Discrepancy Indication Space <br />F <br />A <br />C <br />1 <br />L 20. Facility Owner or Operator. Certification of receipt of materials covered by this form except as noted in Item 19. <br />1 <br />T <br />Y Printed/Typed Name Signature Month <br />Day Year <br />GENERATOR'S COPY FORM NO. 90291 (11/96) <br />