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RECEIVED BY SJCEHD (EF) ON 2/5/19 <br /> � n*1 <br /> Please print ar type.(Farm designed for use an elite(12-pi1c11)typewriter.) <br /> UNIFORM t.GonetatorlDNumber 0 0 5 b 3 1 7 7 0 S K S <br /> HAZARDOUS <br /> 1 Page 1 of 3..E Forrn Approred.OMB Na_205©0039 <br /> WASTE MANIFEST 2' se <br /> �{l 4.ManNest Tracking Number <br /> Gensr1— Name and Mafkng Address 0 5 6 31 �� <br /> 1603 Sa11s S�t�p 10— Loci, Gerreratol&e � ad <br /> ��,(}� � $ S"� Address If different than maifrng addrassl <br /> STOCK'f't'N C,a1 wTva45 <br /> 845 r1ne�hq�s lo— � car:> <br /> � <br /> Generatw'sphona; 2019-3:33--6953 CA 9527 06 SLS' <br /> &.T t � <br /> ami ° . SYSTEMS, Iii( -A 9S240_31,:, <br /> U.S.EPA ID Number7_Transporter 2 Company Name TXT:00008 I�"O F <br /> U.S.EPA 10 Number <br /> 8.Designated Faciliyyarneand SbAdttress Sfit EEN S1'STf;t�F;. <br /> 88TH <br /> WOO STE`EE F INS US-EPAIDNurill ``� �`] <br /> SACFCAt7J~�#TS <br /> r,. 3S6-49131 CAg 32t3 <br /> Fal Phone: <br /> 9a. 9h,U.S.DOTDescaiption(inryuin9 P <br /> RA{ and Packing( pup(d any)) roper Stripping flame.Hazard Class,ID Number <br /> 10.Containers 11.Tata! 1?Unit 1' t+l0N—RtCF(h� N11ZARf?CTIJS b)F+"�T£, LIQUID Ui"? No. T)pe Quantity 12 Uni. 13.waste codes <br /> (At IJEO[15 BRAKE 'LEANER) <br /> G 134 <br /> NC1N— 'CRA HAZARDOUS WASTE, I ZQUZ�} <br /> cr"a (AQUEOUS FARTS UASHER SOLUTION) <br /> 3. f <br /> 4. <br /> 14.Special Handling€n3trrazlons and Aldi tonal lnformalion TS : 7: <br /> 4 EMERBENCY #1-800--46$--3.76() (Sk <br /> At9TH AS "AGENT—FOR" Ry GEM TFi RETAIL! <br /> 15 GI IVERA7QR'3fOfFEROR'B CEIiTtFICRTtON: (hereby de[iare Ehal tine contents of this ons'nmerti an?�i L A �ER8" NSEL <br /> MarkCE��A <br /> IR <br /> Exporter <br /> and labeiedlplacarded,and are in all respects in prow oondi[ion for tran g f*and accurately descnbed above the <br /> Expprter,!certiry that the contents of this cans' sport according to applicable intemationaland oat national proper Shipp ng name,and are dassifred,pa:;:caged. <br /> rgnmant mn�nn to dte terms <br /> of the attached EPAAckN*,edgrrw.i of Consent. 9ovommeniaf ragutationa.If export aftipment and I am the Pnrrrary <br /> I Carllfy ttlal the waste mtn®ntzafion statement identiried in 40 CFR 262.27(a)(:f I am Mity generatcrt orquantity Generator's pf�rois F i erllTYpsd Na ie a large gua (b)[itf am a smart q tity enerator)is true. <br /> 5igna?ure <br /> 6. ❑ SfnternativnalShipments M0„ Day Year <br /> Transporter Import to U.S. a'�i <br /> j <br /> !xs gnature(for exports onlyj� Export from U.S,USPort of entry.r <br /> LUt?.TranaporterActvyntvtetigmentofRoclkiatedafs Date leaving U.S.. <br /> Tof 1 PrintedrTyped <br /> Sonata <br /> 03 0 <br /> Transport P6ed/Typed Name Mpn Da Year <br /> Ir t Signature 1 t1 <br /> Month Day Year <br /> 18.Discrepancy <br /> 18a.DisrrepanLy Indication Sfpace '--? <br /> Quantrty O TYca !�'� <br /> Residue f_J Part atRejecto t f F, <br /> �I!RQiec!ran <br /> Ill Alternate Facility(or Generabrl ktan fest Reference Number: <br /> t3 U.S.EPA ID Number <br /> LL Fa€iRty'sPoona: <br /> u 1do.StgnatureofAlternateFaciftY(or <br /> Gstieratar) <br /> a <br /> Month Day Year <br /> w1 19.Hazardous Waste Rrt Managementepoanagemant Method Codes[i.s.,codes for hazardous waste treatment,d'spoi anc recycgng systems; <br /> (: 2. <br /> 4. <br /> 20.Des grated Name <br /> Facility Owner or Cperatnc Ce <br /> PrintadrTypari Namet fiat ort of recaps orha7arriotts'nate ii Ir <br /> be manifest except as nriad in Item 18a <br /> 7— Slgrature <br /> BPA Fq g7 Z ��� � Year <br /> P���'��n� ���" C)ESIG A ET C F,4ClE.{TY TC} STI � / <br /> 3N STATE(IF REQUIRED) <br />