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BUI of Lading NumtL-r 415295-19 £t7$ts(?s-f3f7� <br /> 415295-19 - ?` g7BILL OF LADING Date©r Pickup <br /> Page 1 of 1 s 19 19 <br /> �erteratraf's Nan1e and Mailin AreasEmergency Phone#(977)577-2669 <br /> 131G DOTS STORES Generator's Site Address if different than mailin address <br /> 300 PHILLIP RD,ATTN:DENA fERARU BIG LOTS#4457 <br /> COLUMBUS,Clic 4322a(614)2784614 2681 N.TRACY BLVD. <br /> TRACY,CA M76 2098308,312 <br /> HM US DOT Description(including Proper Stripping game,Hazard Class and ID nurnt�er) Containers Total Unit <br /> MON DOT REGULATED ELECTRONIC WASTENO. Type/SizO Quantity Wt./Vol, State Waste Codes <br /> DF al P <br /> 3. BATTERJU,DRY,SEALED,"-&tALKALINE BATTERlt35} <br /> 1 Dr is <br /> 4. <br /> Additional IntarmatlE?ft�t3t} <br /> (t)BLEWASIT--%.ER6(l E-WASTE (3)BLALKBATT44-ERGO ALKALINE SATTEMES <br /> Contract/PO No. z Special Instructions/reasons for Delay <br /> No,of ave asks used <br /> Start Time <br /> Arrival at CuStarner <br /> Departed Customer — --- —�� <br /> Delay Time �-._..._.._...._ <br /> G`t"NI_RATOIi GERT7FICATIf3iE _...�_- __ _ <br /> "I hereby declare that the contents of this consisjnment are ruby and accurately described above}� <br /> la6efledr y proper shipping name and classified,packaged,-marked and <br /> PlacaMed,and are in all respects in proper cOnd€tiO"roT transport according to applicable international and national governmental negcEtaticxrs:'I atsa certify that all <br /> times tE&fecl above true 7{tfl£Orre1'.f- <br /> � � <br /> Print Name If k� . <br /> Tractor# <br /> Trailer Box Spotted# Box Picked Up# Liner <br /> Transporter ie T <br /> NAME STERICYCLE SPECIALTY WASTM SOLUTIONS.1NC <br /> I NCJ. I<N8004110924 <br /> Print Name Darryl.Johnson —�$— 19 49 <br /> Transporter#2 Date <br /> NAME ._- <br /> — Phone <br /> EFA Ill No. <br /> ;Print Name. <br /> TSDF Arrival Time Mato <br /> —— Re�On for Delay <br /> TSDF Departure Time —_ <br /> Delay <br /> Finish Time _ — <br /> __ <br /> Contact <br /> — --- — —_ — —�._ Broker <br /> Cosi eelTreament#5torra ld O�Facility EPA Identiftcation Cade No, CARO00210617 - - <br /> Cosigned To:21 St CENTURY ENVIRONMENTAL MANAGEMENT of CA LP <br /> 11855 WHITE.ROCK ROAD, <br /> RANCHO CORDOVA CA 95742 (916)35#-0980 <br /> This is to Certify the acceptance of this waste for treatment store disposal <br />