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1 lJSJ6- (,113121 <br /> Please print or type.(Porto designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS 1.Generator 10 Num <br /> ber 2.Page 1 al 3.Fmeryenwy Response Phone 1.ManNest Tracking Number <br /> WASTE MANIFEST CALMW6412 1 80D-424.9300-CH:ITEC 0 0 0 3 0 0 6 3 7 G B F <br /> 5.Genemtoys Name and Mailag Adtlress Generi Site Address(if ai rte l Ihan mailing address, <br /> MCNEILUS TRUCK&MANUF <br /> 31100 N AD ART <br /> STOCKTON,CA 95215 <br /> Genera is Phone: U.S.EPA ID Number _ <br /> 6.Transporter 1 Company Narce <br /> FreTIOUP Environmental SeMces,Inc. Phone 0500.5533274 IU NM 17fOt7 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> 6.Designated Faality Name and Site Address U.S.EPA ID Number <br /> GEM Rancho Cordova LLC <br /> C-1O• <br /> ="'w' <br /> 11855 White Rock Road <br /> Rancho Cordova,CA 95742 <br /> Facilit'a Phone: 916351-M <br /> ga go.U.S.DOT Descrption(including Proper Shipping Name,Hazard Class,10 Number, 0 Containers Toa 2.Unit 13.Waste Codes <br /> HM and Padding Gmup(if any)) No. Type Quantity WINol. <br /> 1' Waste Aerosols,(Flammable,(Each not exceeding 1 L Capacity)),2.1, DF P 17x.11 331 <br /> c UN7950,PGM 00, <br /> w 2. Non-RCRA Hazardous Waste,Solid (OILY DEBRIS) `^ Od^ OM 5 O P 223 _35 <br /> cD Ch <br /> r =. <br /> 3. <br /> 4. <br /> 14,Special HanWsg InstruCticns aM Atlditionet Information <br /> ALL HANDLERS TO BE 40 HR. TRAINED AND WEAR PPE <br /> 9131) R11882 ERG 0128 <br /> 9b2) R189M ERG M71 <br /> 15, GENERATOR'StOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> marked and Iabeledlplacerded,and are in all respects in proper condition far tampon according to applicable intemationaland national governmental regulations.if export shipment and 1 am the Primary <br /> Exporter,I certay gat the contents of this consignment conform to the tens of the etadred EPAAckrwwledgmenl of Consent. <br /> I Nry tlaI the waste minimiratlon shimment i6entified in 40 CFR 262.27(a)(if I am a large quanfily generator)or(b)(if I am a small quantity generator)is we. <br /> Armin Day Year <br /> mslst06emis Pninadrryped Name Sigrasre <br /> rl Zia O <br /> 2. <br /> tional Shipments ❑import s U.S. ❑Exportacm U.S. Port of-07t <br /> Transporter signature(/or exports Date leaving U.S.: <br /> z <br /> W 17.TrensporterArknowtedgment of Receipt of Materials Tong Day Year <br /> T rte PrintediTyped Na n <br /> O <br /> N <br /> zd er Pain yped Name Signature Mor�g Day Year <br /> K <br /> r <br /> i16.Discrepancy <br /> ism.Discrepancy Indication Space ❑ Quentary ❑Type ❑Residue ❑PaAal Rejection ❑FNI Rejection <br /> Maddest Reference Number <br /> U.S.EPA IO Number <br /> 1111Alternate FarAlly Jim Generator) <br /> M <br /> U <br /> LL Faciliys Phone: Mang Day Year <br /> W 18c.Signature ofXtemats Facility(or Genenalod <br /> W <br /> 6 <br /> Z <br /> 19. azar <br /> Hdous Waste Report Management Method Codes(i.e.,codes for hazetdowaste beaunent,Disposal,and recycling system)G 1 2 3 d. <br /> 20.Designated FacltityOwner or Opemsr.Certification of receipt of haze s materials covered by the marifesl except as octad in Item 16a Mo Year <br /> Pnntedlyped Name Signature <br /> EPA Form 8700.22(Rev.3-05) Previous lions are ate. <br /> 10306.1455 DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />