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SSL SK SHIP# 222664849 �IIIIII gI11111111III111INIII I III <br /> - ,. oo�� oos6raKs <br /> Please or.[pr lym,(FeArr,dasyrad for use on elle 0Z-Oicn)ivuwldr.) Furni Api.f:r.ed.OMB Nu,2050.0039 <br /> UNIFORM HAZARDOUS 'Garw-V IU Nw,�� 2 nye 101 E _dpi'+ 4.lil"WTra hO Numhpr <br /> WASTE MANIFEST CAT0005I39�58 1 tlgtl 'F6ti 0061665'67 <br /> O e•T 6 f1 5'f`7 SKS <br /> 5 Generator's Name and Madng AOc�ess Generators Ste Address(d dlarert Iran rna ing addeesa) U U {� ! y� <br /> Sa€ety—Kieen Systelasl Inc <br /> 5050 Salida Boulevard <br /> SALIDA CA 95368 <br /> cP Efau 5 209-545-1011 <br /> b. Y�RWSYSTEMS INC GS.EPAIDwuwr TXR00$0Q1205 <br /> r EraFer�ddtr P Ccmpgr.}N.a•,e U.S-EPArD Nulrter <br /> 8 D:synaledFabryNam and Site Address THERMO FLUIDS INC US EPA IONvrbe <br /> 1253; SE CARPENTER DR <br /> CLACKAMAS 1 OR 97015-8988 <br /> 503-788-4616 ORQ000025197 <br /> FaCl•`5 Phone: <br /> aa, Ob U S DOT Deswotiat Irdud%Proper Shgxq Name,Hazard Gass.ID Number. 10,Caa11 Total 12 Unit <br /> 13 Ware Galles <br /> Kki and Packeg Group;:zany)} No. Type Quantdy Wt N101 <br /> Ir 'NON-RCRA HAZARDOUS WASTE], SOLID DM ,�M P 223 <br /> o (DRAINED/UNDRAINED USED UIL FILTERS) `T" <br /> w <br /> z <br /> w <br /> r� t <br /> I <br /> 3 <br /> U yrmixlKarrd*•, .•• ' ^ TSDsTPO SSL Cgs.- <br /> 24 <br /> 56:24 HE EMERGENCY N1-800-469-1768 (Sit ! TFI) <br /> AUTH AS "B � .3 S3klF <br /> ENT—FOR" Y GEJJ TO EEIRIN LIELNBED-105—CORRIERS <br /> 15 GE,NEAATOR'S!'OFFEROR'SCERIMATION:lhereby declare twthe=wrt)sur.biscorfiyrmotare fully andwant*dnyk-dmarhyNnvow sl�mm.&Vamdisvii rbax d. <br /> maned and labaiedplacameo,and are v ad respects in pwoer condition ha aanmipKA e:rur t 4 L-upyusawv irlrmorarwr end iaor,at pori pe pal regulatio If e)W v4rrvurt and I am Cie Prmary <br /> E y ulm,I car.*I mt the mrdeals of dds nrsipwwi w Vm t"terms of the SI E PA A, of CaWN. <br /> I MIJ4 %a wntu nuNncdat s:i1u-reM AMtded akO CFFIQW2r(al N I am a I3rgA g,ul VV penemiui 'b RI am a small 7+ermrg p"narv)is true <br /> Yew <br /> J. <br /> 1E 44'rrraxnal Sngrwts f - <br /> U!mporr o U S, C GspoK k,.- tt d U S Poamryl <br /> Trarepdder sigtsaWro(Fx erpors anly?: Date leaving U U 5 5 <br /> D: 17 Tr,7.•vpt WA(♦yyyrap6 rWt of ReCW of MaterAis <br /> rra: 1?tied 1 Nat, �^ 1 Day Y� <br /> MYt V L <br /> C trrr nfeN 59r.Mlrt OOfas C1t, r <br /> L <br /> re p�ca"r�t+�r �t--�Ti I--� <br /> 1Ba dwaparry Irokeuoo Spam U Quawy LIT" LI Resdue Partial Reffed. ❑Ful 9q.. <br /> Isanaed RakV Rr;mtim. <br /> 18b A:emlabe FtlrLty lot Generetdr) U.5 EPA ID Number <br /> L7 <br /> Facility's Plw : <br /> 1Cc Srprature of Anemia Facdmy(a Generator) m Day Year <br /> [i7 19-Hu darn W4 Rcavl LlxnyyLn.a McIrrA Codes ii,e,codes for hazardous walk hwr mni,64pDW.and recrdwv sy.lmm! <br /> 1 2 J 4 <br /> 20 G4974 d Facilrr Owns Operator.Cer_{ica im dremlµd haradun maiaiMs covered by BE nrnCral*ALW u Mb]in Ilam IBe <br /> fmted yped Narrot r Utc C EAD1116 <br /> EfjWN�MA Ioua ditions area le. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />