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1.Shipper's US EP) Document N 2.Page 1 <br /> BILL OF LADING/MANIFEST fl,�f 1�li �.3 of <br /> 3.Shippers Name and Mailing Addre,$JB Hunt — Stoca <br /> 2660 Loomis Rd <br /> STOCKTON CrA vitIrli"I'l <br /> 4.Shippers Phone( 209--)235--1365 4 <br /> 5.Transporter 1 Company Name 6. US EPA ID Number A.Transporters Phone <br /> qAFFTY--V,l FEN SYS1_EMS INC I i x .� q72-PR5-P000 <br /> 7.Transporter 2 Company Name 1 8. US EPA ID Number B.Transporters Phone <br /> 9.Designated Facility Name and Site Address EVG 10. US EPA ID Number C.Facility's Phone <br /> OF CALIFORNIA <br /> 6880 SMITH AVE. <br /> NEWARK CA 94560 CAD980887418 510---795--4400 <br /> Containers 13. <br /> 11.Shipping Name and Description 12. Tot14. <br /> Total Unit <br /> -Tim- No. Type Quantity wt(vol <br /> a. NON—REGULATED LIQUID (VAC—OIL WATER IT <br /> F3L.UDGE) (NOT USDOT/NOT USEPA RkGULhYLD) <br /> =.NOT CA REGULATED) <br /> b. <br /> S <br /> H <br /> I c. <br /> P <br /> P <br /> E <br /> R 7 <br /> TT <br /> 15.Special Handling Instruction and Additional Information ;FJL'A 4 1 L-_ 6L I TZ-7 <br /> K SHIPilfttt"I� JB9793 <br /> _-14 -HR EMERGENCY. -#I—B00_4t"_ 60 <br /> AUTH ,AS "AGENT—FOR" BY GEN TO RETAIN LICENSED SUB CARRIERS AS <br /> ***75813331*** <br /> DOT/PRFL A. 3299/156097 Be C. D. <br /> A) NONE B) C) D) <br /> lgobl 090 <br /> is to raint,that the above-narned am.am property mentrad,deforbod,paCoged,nerevel ined labi are In popme <br /> 1 6a.US DOT HAZARDOUS MATERIALS SHIPPERS CERTIFICATION' 'w"dsition fa Inesponation n�naini to the a enable no ashore of free De therensent of Tran—enenne <br /> Phntedrryped Name Month Day Year <br /> --------------- <br /> 11 Sh.NON-REGULATED SHIPPER'S CERTIFICATION: I notify the materials described above on this form are not subject to federal regulations for Transportation or Disposal. — <br /> Month Day Year <br /> Prin yped Na <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> R — Si lure &11 Day yew <br /> A nted/Typed Name T­ <br /> if <br /> N p <br /> s aq I x <br /> 0 18.Transpedi 2 Acknowledgement of Receipt&Materials <br /> R Printed/Typed Name Signature Month Day Year <br /> T <br /> E <br /> R <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L 20.Facility Owner or operator:Certification of receipt of materials covered by this form except as noted in Item 19. <br /> T <br /> Y Pqajoayped Nam SignatureMonth Day Year <br /> FORM NO.01-90291 (031201 f <br /> ORIGINAL-RETURN TO GENERATOR <br />