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a t <br />•1wa�.ra.�.r Ni.v ••�n�a4 ►�}�Y IRM IYI PN%Jp* <br /> Mh'lll )"Will lot <br /> UkWMM :AR0003 f a,wr.yRr! FAwr>tVr L ►1L?YL�,314+Id,«�' + I'apr�1 cl :S, nlrl�fr4Y IfUNIVlrav ink r ■n �� ra6 rnum lruvnrl pMa No 20%_W34'� <br /> �1�..��a► 5 SKS' <br /> .�rsr�/1 ilhf 7 n0rMkx a, 181 Ir.ra(I dr nrnril lha,1 mytliny 4dflnrul <br /> .:tags olds ■r Of Sufi ktun <br /> .t 'a1 Auto Cantfttr Cir <br /> 5TC_IfTON CA 9"3:12--28'30 <br /> GIt�bYl�rrr �Oy_4�r6-53A6 <br /> >� .rrs �ti Nut*► y 5 TEfl S INC <br /> A 10 Numimr <br /> Tx�lst,or,,, <br /> rot,:�rnrh:C-ria^s NdnV rf�r <br /> I Nu <br /> til t t� r ) 1-i) <br /> a .lw ra,-&,t rril**'+a u"afwx* SAFETY—KLEEN SYSTEMS. IHL U.S.EPA 10NUMbK <br /> 6000 BOTH STREET <br /> SACRAMENTO CA 9H11fi <br /> 916-386-4913 CA0000094�0. <br /> yi C�, U S DOT Description t nciudtny Prtlper Shipping Name,Hazard Class.10 Humber. 10 Containers 11.Totar 12 Unit 13 waste Codes <br /> .4.jarra P"Group{d any)) <br /> No. Type Quantity wravol. <br /> NON-RCRA HAZARDOUS WASTE, L10lJ1U .�.t- <br /> (A011E005 PARTS WASHER SOLUTION) �,fyti <br /> 2 <br /> h <br /> 3 <br /> 4 <br /> 14 Spepal Handling Instructions and A.dditiana3 lnlormation 7616717"1, 174-36" r. <br /> t4 HR EMERGENCY # 800-+468--1764(SAFETY-KLEEN) 1 10,0 C �"-- (-:� f f f- <br /> AUTH AS "AGENT-FOR" PY DFN TO RETATNI LICENSED SUIS CARRIERS AS NFCESSA <br /> 15 GENERATOR'WUFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and socurately described above by the proper shipping name,and are GassrW.packaged, <br /> marlred and labeledlpiacarded,and are in all respects in proper vend tion for tianspon according to applicable intematbnal and natronai govemmental regulations d expert shlprrynt and 1 am"primary <br /> Exporter,t certify that the contents of this consignment oortform to ft leans of the alt�ached EPA Ackrowledgment of Consent. <br /> 1 1 that the waste minimization statement idemified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b){if I am a small quantity generator}is true <br /> rtaeVeqs1Pn tedfTypedt�ame Signature 1 - pay Year <br /> Y P'." <br /> ()��� flsontlr 3 <br /> J 16.I a 5hiprtlsn ` <br /> ❑Import to U.S ❑Export from U S. Po of entryrexrl. <br /> x Transporter srgnailL for ports onfyl' Dale leaving U S <br /> 17 TrarapaferAdwowladclmeni of Receipt of Materials <br /> jT7r i PrinWdgiiW Name Signature Moran Day year <br /> T r , - <br /> Q 3 1 <br /> Tranmporter-2 ledlT ame Signature Mrxrm say yedr <br /> t$ D�e[regarKy f``� ' <br /> laa Dmaeparrcy Indreaaw Space ❑ Quantity ❑Type ❑Rn4us Fulr lin)@,:then <br /> Manrlesl Reference Number <br /> 1 ab Atlemale Faatity(or Generals) <br /> US EPA ID Number <br /> J <br /> U <br /> 1aL FaCdd�S F?•x1r1e <br /> Lu 1 k S,gulure d Alternate Faoity{w Generator} <br /> lnlh Ay -at <br /> a <br /> x <br /> y19 Hazard—Was*Repcxt Management Method Codes h e.,codes for hazardous waste treatment,disposal.and rerydw,g systems) <br /> p 1 2. 3 4 <br /> 2� N-9^sllsd Faalary Oew a Operator Cod alyon of reci ipt of hazardous materials covered by the menrlest ill sk ruled m ftnr 19s <br /> EPAFtxmATPD-ZZ } Pr&lous ed,C6ns are { ' " DrwGf E ,II.ITY M UL.l II , 14 <br /> Scanned with CarnScanner <br />