Laserfiche WebLink
SSL SK 8HIP# 228634320 <br />Please print ot- type, <br />on 6 9 5 3 5 2 3xxn <br />EPA Form ;91 1 Rev. 11-111 Previous editions aro obsolete. <br />DESIGNATED FACILITY T0EPA's a-MANiFESTSYSTEM <br />UNIFORMHAZARDOUS <br />rT��""alor'DNurn-cr <br />TXROOOOB1205 <br />I pace 1 of <br />1 <br />1 3. Emer 'or�", plo, 14. <br />'996-468— 1% - <br />Manifest Tracking Number <br />WASTE MANIFEST <br />'ol,006953523 <br />SKS <br />—Na <br />5 1;u11afdto's ariltlating AddrJ�,� Generator's Site Address (if different than qlating address) <br />SAFETY—KLEEN SYSTEMS, INC. SAFETY—KLEEN SYSTEMS, INC. <br />PO BOX 555 5050 SALIDA BLVD <br />SALIDA CA 95368 <br />INC TXROOOOS1205 <br />7 Trans <br />CLEAN HARBORS ENVIRONMENTAL SVC INC. MAD039322250 <br />SAFETY—KLEEN SYSTEMS, INC. U S. EPA ID Number <br />6000 88TH STREET <br />SACRAMENTO CA 95828 <br />916-386-4913 CA0000084517 <br />91h, U,S. DOT Desoilptimi (10,h1ding Frorer SI-Oppm,, fqam,�; Class. D Nin-ber. <br />10. Cowni ers <br />I I Total <br />12. Unit <br />Quanti <br />TYPE, <br />U! 114 <br />Di <br />NON—RCRA HAZARDOUS WASTE LIQUID <br />(AQUEOUS PARTS W O-LUTION) <br />DM <br />G <br />134 <br />NON—RCRA HAZARDOUS WASTE LIQUID <br />(AQUEOUS PARTS WASHER SOLUTibN) <br />DIF <br />13- <br />134i <br />GENE RATORSIOFFF ROR'S C ERI 1FICATION: ! iieiol� thq! -;i, contents of this consignment aie, fuity and Pl--urately described above by the Proper shipping came, and areclassifed, packaged, <br />mA-1 n,�d ri-�Hiz,�, �rd � e in ail tocnects in cro'��, condfin-, for transport accci6ng loauplic@bie inteinationaland national governmental regu!atiOns. It export shipment and I am the Primary <br />i cer�,fl.l t!ia! ti -c. 46 CFR 262.27(a) (if 1811'. a large qjarilty generator) ci(b) f4l are a sn1a!huqnI;e n<ner�or) is true, <br />_j <br />16. Intereatlol-i! <br />Export frorr U S. <br />Signature Month Day Year <br />--( -A, <br />0 <br />V) <br />f Month Day Yjar <br />I Flo Altef-rmt6 `3cfl,,y (or U.S EPA ID Number <br />LL <br />,j <br />-Faci1ty'sPhone: <br />Month Day Year <br />19. Hazardous Waste Repo,[ hianaaemnntmeth,,111 rides (i,e,, codes fu, hazaralcuswaste Lealment, disposal. and recycling systetns <br />UJ <br />1 <br />41�w <br />2, 7 <br />H141 <br />H141 <br />s —t F 7di, O�,mef or Operator Certirriten of 1c.ri9t of haza;dous, laterisls covered by the manifest except as noted if) Item 18a <br />EPA Form ;91 1 Rev. 11-111 Previous editions aro obsolete. <br />DESIGNATED FACILITY T0EPA's a-MANiFESTSYSTEM <br />