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IIIIIllll423181350BOL 111lI IN f l llll ERI Provider:Clean Earth 4231813 <br /> Bill'of Lading Number Date of Pickup <br /> rAutoZone <br /> 350BDL BILL OF LADING Page 1 of 1 03 18 2022 <br /> A ID: CAL000457130 Emergency Response Phone p (877)577-2669 <br /> s Name and MailingAddress Generators Site Address(if different than mailing address) i <br /> 897 AutoZone#6897 <br /> Pkwy #0336 Trinity Pkwy <br /> 95219 Ph: (209)616.5145 Stockton,CA 95219 Ph:[209]616-6145 r <br /> Containers Total Unit <br /> HIM - US DOT Description(including Prager Shipping Name,Hazard Class and ID pumper) State Waste[odes <br /> No. Type/Size Quantity Wt./Voi. <br /> .� BaneNrs.Dry,Scaled,N.O.S.{Arkallne Botterinl <br /> t 1 CF 00011 P <br /> 2, <br /> I <br /> r <br /> 4. <br /> � r <br /> Addltior•al Information/lab Lade <br /> 1-14)9$27(Al ka line Ba twiesI ' <br /> f <br /> 4 <br /> Spe!:]a]instructions/Reasons for Delay t <br /> 14 <br /> I � r <br /> � � f <br /> J <br /> SNIPPT'S CERTIFICATION <br /> .i hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and classified,packaged,marked and <br /> labelled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations." <br /> Print Name Anthony Mack (On Behalf of Auto Zone) <br /> Date <br /> Tractor p Trailer# Box Spotted# Box Picked Up# <br /> Transporter#1 <br /> NAME Clean Earth Specialty Waste 5ofutions Phone <br /> EPA ID NO.MNS000110924 <br /> Print Name Anthony Mack � Date 03 18 2022 <br /> Transporter#2 <br /> NAME Phone r <br /> EPA ID Nd. <br /> Print name Date. <br /> Destination/Consignee Facility EPA Identification Code No. CAR000210517 <br /> Cosigned To: 21st Century Environmental Of CA Ph; <br /> 19855 White Rock Road <br /> Rancho Cordova,CA 95742 <br /> This is to certity the acceptance 0f this Product or material for treatment,storage,disposal,handling,reclamation,or recycling <br /> Print fame pate <br /> GENERATOR'S COPY <br /> lr Dai tieu <br />