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SSL SK SHIP# 222241944 <br /> 0059469558Ks <br /> Please print or typo.(Form designed for use on elite(12-p[tOijltyptwd r. Form Approved.OMB No.2050403) <br /> UNIFORM HAZARDOUS 1•Generator ID Number 2.Page 1 of 3.E ncy Response Phone �,Manifest TrArzklq Number <br /> WASTE MANIFEST CAL000346561 1 1—�i£taJ-4FSB-17E® 0059 <br /> 46955 SKS <br /> 5.Generator's Name and Mailing Address v Generator's Site Address(if different than mailing address) <br /> TCI Leasing & Rentals <br /> 2150 W Charter Way <br /> STOCKTON CA 9S206--1118 <br /> Generator's Phone: 209-941--4034 <br /> 8.Trans tter 1 C uny Narno U 5-EPAl11 Number <br /> SN0FI;TYT{LEI N SYSTEMS INC I TXR000081205 <br /> 7.Transporter 2 Company Name us f III.�NNyum�]ber /7 r7 7 <br /> L L <br /> B.Designated Facility Name and Site A.ddress CLEAN HARBORS OF WILMINGTON LLC u.s.EPAIDNumber <br /> i <br /> 1737 EAST DENNI STREET <br /> WILMINGTON , CA 90744 <br /> Facility's Phone: 310--835-9948 CAD044429835 <br /> ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12,Unit 13.Waste Codes <br /> HM and Packing Group(t any)) Na. Type Quantity Wt.Nol. <br /> NON—RCRA HAZARDOUS WASTE, SOLID DM IIP 223 <br /> Cr (OIL FILTERS) i� <br /> a` <br /> c <br /> z! 2• <br /> LLI <br /> (:r <br /> 3. <br /> 4. <br /> 14.Special Handling Instructions and Additional Information TSD:W I 73540282 TC 10591 } CSG:�/�// <br /> 24 AUTHR EMAS ERGENCY #1r�800-468-1780 (SK TFI) L t'l°'1 � ,J <br /> 15. GENERATOR'SIUFFEROR'5 CERTIFICATION: I hereby declare That the ranWls of Ihls consignment are fully and aCatraloly dssMbed above by the proW shlpNng name,and are CWWfied,packaged, <br /> marked and labeled/placarded,and are Mau respects in proper candilim for W.Vtspori aeoording 10 applicable intorriffWaland national governmental regulations.tt export shipment and i ant the Primary <br /> F-xporlor,I ceriffy that the rnn'.ents of this cws0imanl conform le ft leans of to attached EPAAdcnewledgmant of Consant <br /> I cerli[y that the waste minimimtkn stttament Identilfed In 40 CFR 262.27(a)(if I am a large quartily garters or(b)(ti a Irue. <br /> Genefalur eror's Pr mU.&T. amp ` Signat Day Yaw <br /> witJ 16.Iniemallonal Sh prnents (p[) <br /> E= ElImport to U.S. ❑Export from U.S. Porl of entry/it.:ortar signature(for eK"s only): dale leaving " <br /> du tf:T.rMa erArkmwtedgnterd of Receipt of Materials <br /> Tra r i PrM.4W Nla�men, Stnalnm Month Day rK"r <br /> Trensponur 2 P Ina V Signature Month Day Year <br /> jr �✓IS `�� .� 1 <br /> — 18.Oitxxepandy i <br /> 18a.Discrepancy Indication Space ❑ Quantity ❑Type Residue❑ ❑Partial Refection ❑Ful Rejection <br /> Manifest Reference Number. <br /> 1: 18b Allen}ala FacAlty(or Generator) US.EPA O Numloer <br /> .3 <br /> LL Facility's Phone: <br /> I&.Signature ofAltarrafa PaciNty(or Nneratar) Mdhth nay Year <br /> 19.Hazardous Waste Report Management Method Coifes(Le„codes for hazardous waste treatment,disposal,and recycling systems) c <br /> c5 ' 2. 3. a <br /> HtiU� <br /> — _ <br /> 20.Designated Facility Owner or Opefalar Certification of receipt of hazardous materials covered by the manifest except as noted in Ilem 18a <br /> rmtad7Typod Name Sigftalum Month Day ear <br /> ---- <br /> E PA.Form 8700 22Re33 <br /> --qq <br /> v. 6) PTSVIDUS editlOnS are obsoiete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br /> 1)7f IQ� 115JE777 _-- <br />