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Daniels Arpsmart Inc. Tel: 559-834-6252 Manifest 713144 <br /> 4144 E Therese Ave Fax:559-834-2242 Customer 10442 <br /> Fresno CA 93725 Old Location <br /> For Chemical Emergency Date- May 2& 2013 <br /> SPIII,Look,Fire,Exposure,or Accident <br /> Call CHENITREC Day or Night Twesday-626 <br /> '1-800-424-9300 ifillillilillill <br /> 7 1 3 1 4 4 <br /> Generator: <br /> State 10 No.: Carrier: Transporter Permits: <br /> Daniels Sharpsmart, Inc.-Fresno Daniels Sharpsnjart, Inc. CA-4707 <br /> 4144 E Therese <br /> 111 W Jackson Blvd EPA#CAL000344393 <br /> quits 720 <br /> Fresno CA 93725 Chicago, IL 6cr)o4' <br /> Attn.'Nic.k Roscito US DOT A 1295076 <br /> (559)834-6252 312-546-8900 <br /> Vehicle Decal: <br /> nation Facility: Alternate Destination Facility Transfer Facility-­ <br /> Daniels Sharpsmart inc. Waste Management <br /> 4144 E Ktdical Waste servicts <br /> Therese Ave 7505 State Hig,),t�ay 65 7:121 oujillby St <br /> Phone, Fresno CA 93725Anahuac TX 77514 Siqrjaiu�e.Date PararlfwUht.CA 9G723 Tran fir Signature&cater <br /> 559-834-6252 Phone: 409-267-3913 <br /> Permit 0: TS,'OST-55 Permit NSW22-39-A P"O'le. 661-600-4368 <br /> R. T&OST,94 <br /> Wa to Collected: UN 3291 Regulated Med—leal Wa-ste n,o.9 6,2 PG It <br /> ShartrsmartC nt-i---- Pharmaceutical laMedical Waste <br /> ime -Q—ty P ? 49921aa�� Trace Chem2LIterao <br /> e NILW—L 7 <br /> PA NetWt ime 911Y filet Wt. <br /> S14 <br /> Za701 28 GAL <br /> S22 S22PH38 GAL <br /> S32 'A. 9G GAL SubTotal <br /> S 14A+ 822PHA+ <br /> S22A+ Total Containves <br /> 332PHA-P <br /> StibTo, <br /> 32A+ S64PHA-f. Estimated Gross Les <br /> ;564A+ SubTortat fthml m (at pickup): ...... <br /> SubTotal Total NET Lbs, <br /> Tran-Sporter ID's Returned: (11G) (MED)�--­­_____,______ (Sw <br /> Clean Products Delivered: <br /> Lroduct. Ordered: <br /> Droo off RMW <br /> 1.00 Notes Comments or Discrepancies: <br /> L 5 7 <br /> A(6 1 <br /> Alternate Destination Facility <br /> 0-75'71,1 Name- Curtis Bay ErerW <br /> I Address: 3200 Hawkins Point Road <br /> City/statelzip: Baltimore,MD 21226 <br /> Phone: (41 33228 <br /> WMW036 <br /> Generator Certification; I he-by detlare that the content at his consignm <br /> ent are rote asci uccuratelydescribed above by vroper shipping name and are classified, 3, <br /> packed,, marked,and labGred,and are in all;Spec's in proper condition to,*transport according to applicable government regulations <br /> I further declare that this shipmen!of waste is free of hazatdour,ano Mercury waste as defined by the US code of fellers!regulations ar�dor <br /> (C ) apprjr10te sl rules and re u at Hiss. <br /> Genera ustomer : <br /> IF' <br /> Name of authorized person(print): <br /> Route Driver: Datc <br /> Ni Applicable) Nam orizedp, cn(print) lure Date <br /> Transfer Driver: —a 10 <br /> qgljjiil�� <br /> r <br /> 27f,41ak i;�I ,I ��1 1 - 13 <br /> Name of authorized person(pritit, 11 sj!anatkvQ — <br /> Certification of receipt of waste as c�vs*d by rais rnanHest norihw% Date <br /> Certificate of Receipt: <br /> Name of authorized persc,n(printSs s <br /> Certification of receipt and dastrixti;n o�watle as cover bytizzmann number DatG <br /> tifiCate of Destruction: <br /> 6 <br /> Z <br /> Name of authorized pwsoii(pfjq,,) <br /> 31�jn ore Date <br /> I <br /> Willie Green C^ai,,ary ule <br /> Cetiificat&Of Retur,to ilustorrgr Pink Gold <br /> T,,Rnspirter <br />