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Excluded Recyclable Materials�PPP�lject Nuynb�f 2.Docu n-LIN, umber 3.Da e <br /> Standard Bill of Landing <br /> 4.Generator's Name and Mailing Address 5.Generator's Phone <br /> 6.Transporters I Company Name 7.Transporter's Phone <br /> 8.Transporter 2 Company Name 9.Transporter's Phone <br /> 10.US DCT-Proper Shipping NJe <br /> 11. Containers Total Quantity 13.Unit,Wt. Recycled Pursuant <br /> Type Volume to HSC 25143.2 <br /> C. <br /> D. <br /> 14. ecycling.Facility Name and Mailing dress 15.Facility Phone <br /> 16.Additional Description for Material Listed Above <br /> 17.Special Handling Instructions <br /> 18.Generators Certification:/I(hereby declare that the contents of this.consignment are fully and accurately described above by proper shipping name and are classified, <br /> packed,marked,labeled and are in all respects In proper condition for transport according to applicable international and domestic regulations. <br /> I also recognize that in spite of product name or appearance,these commodities are being recycled and are either non-hazardous or conditionally exempt from <br /> hazardous waste regulations.As the generator,I.am making a good faith effort to minim lze my waste and am taking advantage of new technology and existing DTSC <br /> regulations to com y-with SB 14 requirements-by selecting the best methods tha re available to me and that are economically practical. <br /> Ge for or Authorized Representirie/Print Name SigPre th Day Year <br /> Y!±>( Y,p <br /> 19.Transporter-1 Acknowldgement of Receipt of Materials — <br /> Print/ pe Name Sign a Mo t^ Day Year <br /> 20.Transporter 2 Acknowldgement of Receipt of Materials <br /> Print Type Name FPrint/Type Name Month Day Year <br /> 1,7 <br /> j .7 <br /> 21.Discrepancy Indication Section <br /> 22.Facility operator:Certification of Receipt of Exluded Recyclable M/serials by this Document except as otherwise noted online 21 <br /> Print//Type Name Signatur /�' ,j Month Day Year <br />