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215028-19 MINIMUM <br /> 0023()1 a53PSC 3561143-001 <br /> 3 - Fwd.418 Ko:Mr,0-039 <br /> U13IFt)FiPA H ARD4US T Generatrr ID Number k' 2.Page 1 Df 3,Erreryr ocy Tikspun a Phone d.Manifest 7racicing Nrmlher <br /> WASTE MANIFEST CALWp391Q73 (877)577-26 9 V0L.30 $�J3 i r <br /> 5 Gcnerat tttarnea�rlN `IinyAzr;ks Cserkiatu�sSile s{ dilfEre than mailing address; <br /> BlC,LOTS STORES BIG LOTS*4457 <br /> 300 PHILLIP RD,ATTN:oENA FERARU <br /> 2fi81 N.TRACY BLVD. <br /> COLUMPUS,OH 43228(614)278-4514 <br /> Generdar s Phone TRACY,GA 85376 2098306312 - <br /> b-rmospor v 1 CGrltpany Name U.S.EPA ID Number <br /> STERICYCLE SPECIALTY WASTE SOLUTIONS INC MNS000110924 <br /> 7.7 rarisporipr2%mrtrparty Name !�{! � �� 11.5.LPA ID 14wn�1 <br /> 1 !pd-o v f <br /> 1'-Oesgarterl Facility Name and Site At dress ffumber <br /> U.S.CPA1D <br /> 21st Century Environmental Management of Nevada LLC J-S EPA 08m533B <br /> 2095 Newlands far.East, <br /> Fembey NV 89408 (775)575-2760 <br /> l-a(il4ys Pho�te - <br /> tty u.$,lH]T O i rpt ari(indrxlitg PropPrShipp ng Narrre.Ha <br /> rard C.mss,ID Number. 10.Containe s 11.ialry 12: <br /> wo and Parking Croup fit*)) .. Nr s Type QuanlJy NMI. <br /> 13•Waste Cones <br /> I. UN1993 WASTE FLAMMABLE LIQLADS,RO.S.(KEROSENE.DIESEL)3 PGII <br /> �( 331 { DOQt ( ppQS <br /> t of Ii !' _ <br /> LLJ0007 0018 .p635 <br /> LQ - <br /> 3. UMMo VYABTE T0jjC,LIOl11M ORGANIC,N.D.S.(2,4-A)G.i poli r <br /> 331 Dpi6 <br /> 1 DF 29 .13 <br /> ' ! 4 <br /> r <br /> 19-Specaf Handrg iasUuclionSarxl Additlorlal Information <br /> (1)HLFLAMLM-W-E1tG(128)FLAMMABLE LIQI f[DS P)BLTO)M-M-ERG(IU)TO)aC LIQUIDS I-OOSEPACK <br /> 15 GENERATOR'VOFFEROR'S CERTIFICATION:f hereby declare 1l the coil". Of This conslgnm rx'pu11y acrd acraxalely des t..... ahnve%,the prmp?r Shipp np name,and ace classified.packaged, <br /> rnarksc ams!IaOelorilglaGgrdGd.andate aN tespe€is Jr proper certdtiom fof b mlispo l according 1R'appllcaW rnterrraf stand nationargoverturrdfgal regrkmns-If export Shipment and I am W.Pr rsrary <br /> fxti� r)cedily that lite contest rrs gr rnenl conform to the terms Of the ai3ache0 EPAArkn(A e <br /> e tity the waste"n"06—,stal,nl ldentified in 49 CFR M2.27(a)(d 1 am a large quon2 r or)Gr i a n;+ all yrDntty genefalor true. <br /> fierier ri =,tffypcc Idarme SigFialure MonC Day - Year <br /> ti <br /> � T5.lnlemati^.nal3hifrnfemtst� _ <br /> 4 - 29.1 •.19 <br /> i-- LEimpodhou.s. - ❑F*I''m LI.S. Pon ofemtrylexfe <br /> ? 1'rans(,oder signatrire(forexports Dirty}: Dale Leaving IJ S.. <br /> 3 T.T ansp iakw kknowbdrgitent of For-eapt of lrtatgrols <br /> ►-- T;anm atLr'1 Prialed'Typed Name <br /> Sigw e <br /> Month Day Year <br /> O <br /> c" vG 4 29 19 <br /> Trargp�trar Pr rRet)fTy(1ed lJdrtte lire 1vtm, Day Yea <br /> - <br /> I&-D:sctcpanc . <br /> 1A1.Djxff p sng hrrlicatian Space Qua r [[��'�� <br /> R5' L_1 I ypo ❑Resitiue ❑Partial Rejection ❑Full Rcyvclion <br /> Manifesl Referertee Number: <br /> TR).Nlemste Faritly(or Generator} U.S.EPAID Nwibcr <br /> C? <br /> W Sig!Sar4e ulAtam ale Faolity(arGeneratorJ fdomth Day Year <br /> !r <br /> 4 <br /> 1 S.fSaeardrtus WAe Rencxt Management Pile!hod Codes(i,e,,aides for hao*us waste Irealtrlera,dLiposal•Tu1d recyong systems) <br /> w 1 <br /> d. <br /> Q H141F H141 <br /> 1 3c5[Ir)el�1 fariily O�rner(jrOperafir.GerlHiLafirxl of re€eyst G1 nnzardmus mater a�covered t y the rn 1n .'t esc pl`as tided in fleet 100 <br /> ' Aedpaeri NarnG - "T7,alar <br /> Muillh h3aq rYea <br />