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DTSC. 02897- M* <br />ern rand n ,I ee.m dee ed (m elltn 119-ndrhl <br />Farm Approved. OMB No. 2050-0039 <br />Www <br />i.. ,....... _.. _. y. <br />UNIFORM HAZARDOUS <br />.. l_to_D-_.-,._�__ .,r_..... _.., <br />1 Gelembr ID Number <br />2. Pagd1'oi <br />'3. mergenq Response Phoria <br />LManNasl Tracking Number <br />011626663 JJ K <br />WASTE MANIFEST <br />CAL000276800 <br />209-982-1041 <br />5. Generators Name and Mailing Address Generators Site Address it different than mailing address) <br />G I Trucldng Co. DBA Estes West 7811 S. AlrpdrtWay <br />3910 W. Broad St. Staics CA 95208 <br />, <br />Richmond, VA 23230000 <br />Generators Phone2019.08?1SM <br />6. Transporter 1 Company Name _ U.S. EPA ID Number <br />California Entoronmarltal B Lill to CARDOODO9910 <br />7. Transporter 2 Company Name U.S. EPA ID Number <br />Asbury EnwonmentalSenrica5 CAD028277030 <br />8. Designated Facility Name and Site Address U.S. EPA ID Number <br />Demennokardocn CATOBOO13362 <br />2000 N1 Alameda Street <br />Compton, CA 90222 <br />Farrhi's Phone: 310.537-7100 <br />ga <br />9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, <br />10. Containers11. <br />Total <br />12. Unit <br />13. Waste Codes <br />No. <br />Type <br />HM <br />and Packing Goup(ff any)) <br />Quantity <br />ilii <br />0 <br />1 Non RCRA Hazardous Waste, Liquid (Waste oily water) <br />D� <br />, r5D <br />L� <br />G <br />221 <br />V <br />V <br />z <br />z. <br />w <br />13 <br />4. <br />14. Special Handling lretructionsand Add Non Info `%�t nn L \ <br />i. We to oiywatar 3 ( vs9'o(l'eylvi ERG#171 <br />�0r5 /' 55 <;-) Ri it, I, WGSL <br />15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignmen re fully and accu Lely described above by the proper shipping name. and are classified, packaged, <br />marled and latleleNpiacarded, and are in all respects in proper condition for transport aaording b rap moble intemaiona rid national governmental regulations. If export shipment and I am the Primary <br />Exporter, I certM that the contents of Nh consignment conform to the terms of the adached EPAAdm wledgment of ant. <br />I ceN that the waste minimization statement identified in 40 CFR 262.27(a) (111 am a large quantiTy enerator) or (b) r generator) is We. <br />Generatof em's Prime tlR <br />on ignalure NoDayDaay/y'' Year . <br />lQ IQ <br />J <br />F <br />16. Intl anal ShipmentsEl <br />mport to U, S. Export horn U.S. Part of enuylexic <br />Z <br />Transporter signature (for exports only) Date leaving U.S' <br />W17. <br />Transporter Acknowledgment of Receiptof Materials <br />Tmnsppw R.7Wed rd Name Signaure - Monty Day Year <br />QTransporter <br />2 PdetedRyped Name Signature Month Day Year <br />W <br />1 <br />18. Discrepancy <br />fila. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Poll Rejection ❑ Full Rejection <br />Manifest Reference Number: <br />18b. Alternate Facility (or Generator) U.S. EPA ID Number <br />J <br />U <br />ra.. <br />Fadliys Phone: - <br />W <br />tile. Signaure of Alternate Facility(or Generator) Monty Day Year <br />Q <br />2 <br />19. HdZardeUe Waste Report Management Method Codes (ie., codes for hazardous waste treatment, disposal, and recycling systems) <br />Go <br />wo <br />1. ^ <br />3 <br />2. 3. <br />4. <br />20. Designated Facility Owner or 0peramr. Certfication of receipt of hazardous materials covered by the manifest except as noted in Item l8- <br />1 <br />Punted yDetl Name Si Month Day Year <br />- <br />6 <br />/ <br />EP Form 00-22(Rev.3-05) Previous e' samobsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED) <br />11796.1151 <br />