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JEXCILlded Recyclable Material I. Bill of Lading it <br /> - <br /> Manifest 2. Document Number <br /> r' USR 2018-000_ <br /> 4.("-ne tor'sName and Mailing Address <br /> 5.-Generator's Phone <br /> Universal Service Recycling,Inc.3200 S. El Dorado St.Stockton,CA 95206 <br /> tT1r'1_nspor_t209-944-9555 <br /> 7. <br /> Company Name 7_Transporters_Pf�clrt_e_ <br /> Universal Service Recycling,Inc.3200 S. El Dorado St.Stockton,CA 95206R.Transporter 2 Company Name 209-944-9555 <br /> 9.1"'IsPul ter's Phone <br /> 10. US DOT Proper Shipping Name <br /> 11. Containers 12.Total Quantity Ft.Unit,wt. lil-LYCIOd llonsUjnl <br /> N. rvm <br /> A. vollion, to HSC 25 143 2 <br /> Metal Shredder Aggregate-Excluded Recyclable Material 001 IVI' ISV <br /> C. <br /> 1-4.—Recycling Facility Name and Mailing Address <br /> 15. Facility Phone <br /> Universal Service Recycling Nevada I.I.C.5855 Sheep Dr.Carson City,NV 89701 <br /> 1�16.Additional Description for Material Listed Above 209-944-9555 <br /> Mixture <br /> of materials containing Plastics and recoverable Metal;coarse and fine-grained materials including recyclable metals,recyclable plastics,and <br /> a Ing foam rubber,insulation materials on-recyclable materials including foam rubber,insulation materials and entrained soil and grit.Shipped aggregate is an excluded recyclable material <br /> coder s <br /> s <br /> mcler the provisions of subdivision(d)of Section�25143.2�. <br /> 17.Special Handling Instructions <br /> N N 0 special <br /> ci,I Ii <br /> e handling No special handling required;inquiries contact: Universal Service Recycling Project-Excluded Recyclable Material <br /> 24 Hr.209-751-9946 for Environmental Health and Safety Manager <br /> Gel-raftir,Cvnificiotinn:I hereby declare thin the coil,•--- <br /> pickud. f this consignment are fully and accurately desnibeclabove fly prnpel shIppiol!11,111le�IIILI;III,(:I, <br /> ""'ked,labeled are in all respects in proper condition for transport according to applicable domestic regulation., <br /> Warne or appearance,tiles <br /> I al"',wCopni/v than III spite til product Issill.-H, <br /> these commodities are being recycled and are either non-hazardous or conditionally ,xt.lopt I <br /> rum <br /> ild?,11HOW,WdSte regulations.As the generator,I am making good faith effort to minimize illy waste and ln,t� <br /> 11e <br /> -111011%10 comply with Sit 14 by selecting the best methods that areavailable to me and that are economically practical. <br /> c !lit:D I%(- <br /> Ikinadvantage of new techool,�I�Y,ln(l exist <br /> �('(!Ilel,ltoi or Authorized fiepresenlative/Print Name Signal tri <br /> UnthfDay Year <br /> j I7 111),te,�1111 I It e'Ti"',fit of Receipt of I' <br /> Print rvrlf.Nan),. - ------ <br /> Month —DAY year <br /> f Materials <br /> ransporter 2 Acknowledgement J-Receipto <br /> Print/TYpj Wine Print/—Type Na—n,(, ----- ---- <br /> _TMOnlIl <br /> 1. Discrepancy Indication Section <br /> Facility Operator: Cort"lic-ati-oin—of-—Receipt of Excluded Recyclable Material;by(ItisDoctilln'til except as Ulll(-'w ('l, "OU'd on hin.2,1 <br /> Punt/ yp 0 N <br /> ame signatur <br /> Ely ye"r <br /> nI <br /> Yk Moth <br /> ---- 26 ( C <br /> -------__ _ <br />