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JX SKIP4 2MIRSBOS 11111111 M 11 milli 1111111111 <br /> 0063634626 KS <br /> Please ont or type.(Form d fled fm use on epte(12-pW)typewnter.) Form Approvae .OMB No.2056-W39 <br /> UNIFORM HAFARDOUS j"'-C*wgW'DNwrber CADM.48v3S 2.Page t Number <br /> t 311r 11 ny =44-'w <br /> t Ma€�t,T,� 62SKWASTE MANIFESTfr�76.t3anerata s Harm arxi AdatknB Atttlres� C�t€eratars S�A6dress cd ftn rr�i N address) <br /> Cal-•Tr4n5 Shop Ip- Lard Cal-Traris Shop 1,0-- <br /> 1603 S R St <br /> .4--.1603SRSt 84�iE Piyl L� St <br /> 3TOCkTON CA X5306 <br /> Ger ots s: 209-3'13:-6993 art <br /> 6. wghr U.S.ERA fD Number <br /> 7.Transporter 2 Company Narne U.S.EPA ID Number <br /> 8.DawaW FacftNameand5ibe Addirass SAFETY—KLEEN YSTEM€ , sINL;. U.S.EPA IDNu€nber <br /> 6000 83TH STREET <br /> SACRAMENTO LA 9582E <br /> X16-���•-��.j,3 CA€t�GC�(:,�:� . <br /> F 's <br /> . 8'3.U.S.DDT Desatptim(mdudt•,g Proper SltippN Name,Hazard£Sass.V Number, ?4.Contac 11.Total '2.Unit 13.WaW Codes <br /> Ht. and Pam Grouts(if any)) M1 c. Type Qllardity wuV-1. <br /> t NON-RCRA HAZARDOUS WASTE, LIQUID � 0 134 ? <br /> (AQUEOUS BRAkE CLEA€SER) <br /> z 2,NON--RCRA HAZARDOUS WASTE, LIME) <br /> (AQUEOUS PARTI S WASHER SOLUTION) <br /> 3. <br /> t <br /> 4. <br /> 4.5pecAHancfinglnshuctlonsand Additional Womabon `50 KA E A 5 3 u',1743 C56-13 <br /> 24 H F TIER NCY #1-800-468-1760 (SK TF I) 1.10 <br /> � <br /> AUTH AS "A NT FOR" BY GEN TO REI AIN' LICENSED SUP CARRIERS AN€,ESSAR <br /> 96, GENERATOR'SKMROR'S CERTIFICATION: I hereby dee6are that ibemntents of Itis wrisOument are ft*and accuratelydesed4ed above by the proal stappinq narma,arcs are clasHt w pada*. <br /> marked and lab&d?ptaca&ed,and are in of-:respects in proper wAdition for trarispod acoardiitrg to appticabie as rrratigoatar€d W4rlai Wrvernrrontal Vis.if export 5hPMW4 anq 1 am t'te Pr4Mq <br /> Exporter.f certify that the contents of this sxzns pnwt caeform to stye terms oft*arae ied EPA AdwoMedgm€ent of Coranni. <br /> I certify€fat the wase minimizaew statement identified in 40 CFR M27(a)(if I am a Iarge quarmy generate or{b)(if t err€a srnab qum*generatic)is hve_ <br /> :8bri'st S Priv rTyped Manta S' Mo ttlt Day Year <br /> V7 <br /> ri 15.International S Iwman <br /> ElImport to U.S Export from'us. <br /> Transporter s=r}naBue{rw a�puds c�ly]: �81e€eav'ng U.S.: <br /> � "=.7,Tra>YaporlerAtttrrosr3edgn^9ntOfRBcai�oft�ateria�s /}..Jyt <br /> TF PnntadlT Name Signature Mom`s€ Day [Year <br /> 0 <br /> Trans"r 2nd>%dName Signature Monlh Day Y"a' <br /> 18.Discrepancy <br /> 169 Discrepancy imitation Space 0 Quwtity ❑Typo ❑Resin <br /> 0ParcialRFjecticN, 1—IFr0.IRiqatiiott <br /> Man•mess Referww Nusrber: <br /> t 8b.Alt iwAte Fadkty for Cw attxl U.S.EPA ID N mbe' <br /> cQc. Fac kty 5 Prone. <br /> tic.Signature of Aitwk to Fad(y forG Ierator) r,wh Day Yea; <br /> Q <br /> Z <br /> ZT, 13,Hazantous Waste Report Mani€erment Method Codes(i.e.,codes for hazardous waste treatmant,disposal,aid retpdN systems) <br /> © t H 1.4 2 ;,,1 :i a. 4. <br /> t <br /> Designated Facilly Owner or Operator.CeOcatioe of receipt of hazardous rreterlmis revered by the manifest except as riled in Item i8o <br /> EPAF ( i i P ; " '` s DESIGNA D FACILITYTO REST► AT10 STATE(IF REQUIREDI <br />