Laserfiche WebLink
BILL OF LADINGIMANIFEST I.Stripper's US EPA ID No,(if Applicable) I Document No. 2.page 1 <br /> CAk000039370 . - of 1 <br />• 3-Shippers Name and Mailing Address 1905 Mch e n r y A v e <br /> ESCALON CA 95320--0000 <br /> 4.Shippers Phone( 2097552-6051 <br /> 552-5051 <br /> 5.Transporter 1 Company Name 6. US EPA 10 Number A.Transporter's Phone <br /> SAFETY—KLEEN SYSTEMS INC TXRO$00$1205 . 800-669-5840 <br /> 71 Comp� Nam ']umber I Transporters Phone�VeL <br /> !r 6f V <br /> 9.Designated Facility Name and Site Address Si 10. US EPA ID Number C.Facilitys Phone <br /> CLEAN HARBORS SAN JOSE <br /> 1021 BERRYESSA ROAD <br /> SAN JOSE CA 95133 CAD059494310 408--441-0962 <br /> 11,Shipping Name and I]escription <br /> 12.Cont finers 13. 14, <br /> Total Unit <br /> HM Na- Type Quantity, wwol <br /> a. UN2800 BATTERIES WET NON—SPILLABLE, <br /> X 8, UNI4ERSAL WASTb—BATtERIES 1 DF �5 P <br /> b. UN2795BATTERIES WET FILLED WITH ALKALI, <br /> X e (UNIVf�ERSAL WASE BATTERIES) DF P <br /> S (ERG#154) <br /> H <br /> UN 1950 AEROSOLS FLAMMABLE IN O. S. <br /> P X 2. 1, 41N I VERSflLtASTE -� AERbSOLS) DM P <br /> P 1 E <br /> Rd. E NON DOT REGULATED MATERIAL, <br /> I V�RSAL WASTErLAMP 5r� P <br /> 15-Sp lel Handiir�lnstr. 14 <br /> Stion and Additional Irtformabon <br /> -lD 4 V651 "$ SK 5H I P# 235244209 ES 1201.4 <br /> . <br /> 1)ERG#1542) G#154.3)ERG#126; <br /> 24H EMERG� 8010-468-1760(CH—SK--TFI)—TRANS AUTH TO RETAIN ADD'L CARRIERS <br /> DOT/PRFL A. 8938704/1879304 B. 8291559/158608 C. 8681266/1.879295 D. <br /> 868336811879296 <br /> A) NONE B) NONE C) NONE D) NONE <br /> I <br /> 16a.US DDT HAZARDOUS MATERIALS SHIPPER'S CERTIFICATION: rhrs m**(Y that ma abrn"Urred mala ads are Property dBs 606 dela bed,Pari axed,marked and Labeled and are In Proper <br /> conditipn far tra Son aocardln m tha a lkable bons of the Ue ment aFIvan ortalion- <br /> nntedlTyped Name ] D ]� Monro pay Year <br /> L--� 0MC___= _,_(a 17A 1-24 <br /> 16b.NOH-REGULATED SHIPPER'S CERTIFICATION. I certify the materials described above on this form are not subject to I regulations for nsportation or Disposal- <br /> PrintsdlTyped Name V a <br /> Monrh Day rear <br /> T <br /> R 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> A Printedffyp a a <br /> N Sig Month D*y Year <br /> P <br /> r <br /> ❑ 18.Transporter 2 Acknowledgement of Receipt of Materials <br /> I���Prnintod/Typed Name Sl nature <br /> E g Month Day Year <br /> R G <br /> 19-Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> LL20. ility Owner or Operator.Certfiication of receipt of materials covered by this farm except as noted In Item 19. <br /> fe yped NaIT'e Signature Mona, Day rear <br /> ORIGINAL-RETURN TO GENERATOR FORM NO,01-90 (0342015) <br />