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SSL SK SHIP# 3"JW' <br /> Please print or type.(Form designed for use on elite(12-pitch)typewriter) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Man!(W TraekiNumber <br /> WASTE MANIFEST CAL@00352832 f. 1-$Q10�-468-1768 n Q 5 A�umSKS <br /> 5.Genemtors Name and Mailing Address Generator's Site Address indifferent than mailing address) <br /> Gardner Trucking/Classic Sales In <br /> 2577 W Yosemite Ave <br /> MANTECA CA 95337-9641 <br /> Generators Phone: 785-690-0109 <br /> 6.Tran rtor 1 Com an Name U.S.EPA ID Number <br /> SAEfiV-I�LE�EN SYSTEMS, INC. TXR@088812@5 <br /> 7.Transporter2 Company NameU.S.EPAIDNumber <br /> 8.Designated Fadliy Name and Site Atldress CLEAN HARBORS OF WILMINGTON LLC U.S.EPA ID Number <br /> 1737 EAST DENNI STREET <br /> WILMINGTON , CA 90744 <br /> 31@-835-9998 CAi'�444Z9835 <br /> Fact' sPhone: <br /> ga. 9b.U.S.DOT Description(axtludmg Proper Shipping Name,Hazard Gass,ID Number, 10.Containers it.Total 12.UnitHM and Pecking Group(R any)) No. Type Quantity Wtivol. 13.Waste Codes <br /> 0 NON-RCRA HAZARDOUS WASTE, SOLID DM � P 223 <br /> (OIL FILTERS) <br /> z 2. <br /> w <br /> 3. <br /> a. <br /> - 74.Buscot Handling Instructions and Additional Information TSD:WI 7154@@14 GAISS65 CSGz <br /> 24 HR EMERGENCY N1-800-468-1760 (SK f TFI) <br /> i " <br /> n <br /> 15. GENERA SlOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and aami ately described above by the proper shipping name,and are classified,packaged, <br /> marked and labeleciplacarded,and are in all respects in proper condition for transport acanding 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 he waste minimization statement identified in 40 CFR 262.27(a)(d I am a large quantity generator)or(b)(kit am a small quantity garrerator)is true.. <br /> GeneratorslOfie 'nted/lyypetl Name ��✓} Signature Day /ear <br /> �V` �. P p=Zw i ..ate"a"�'(,+.._ tz <br /> 16.International Shipments <br /> F ❑import b U.S. EJ Export from U.S. Port ofentryf"t <br /> Transporter signature(for exports only): Date leaving U.S.: <br /> W 17.TransporterAcknowledgmed of Receipt of Materials <br /> Tragill 1 Primed`(Typed Name Sign Month Day <br /> Year <br /> H C.vtCi✓1i �/ 10 104 <br /> Trensporter2 Prinlad/Typed Name Wre Month Day Year <br /> 1- o G <br /> 18.Discrepancy <br /> 18s.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue <br /> ❑Partial Rection ❑Full Rejection <br /> Manifest Reference Number. <br /> 18b.Alternate Faciity for Generator) U.S.EPA ID Number <br /> J <br /> U <br /> LL Faclitys Phone: <br /> W Ii Signature ofAltemate Facility for Generator) Month Day Year <br /> tz <br /> z <br /> y19.Hazardous Waste Report Management Method Codes(i.e.,codes for hamrdous waste treatment disposal,and recycling systems) <br /> 0 1 (7 / 2. 3. 1. . <br /> 1 20.Designated Faality Owner or Operatw.Certification of receipt of hamrdeus materials covered by theman fes except as noted in Item 18a <br /> PrintedRyped Name / SignaWre Month Day Year <br /> ih <br /> EPA Form 8700-22 Rev.3-05 Pre ' s editions are obsolete. ` <br /> � DESIGNATED FACILITY TO GENERATOR <br />