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Please print or type.(Form designed for use on elite{72-pitch)typewriter.) .^n Aoproved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS Generz;or!D Number 2.Page 1 pi 3.Emcr2eay aes,c=:e Phere x.Manifest Tracking Namber <br /> WASTE MANIFEST ,-, J J K <br /> 5,Genehuor's Nams arid Mining Address Generators She Ar!7 ese!II9i3erent Char=ma'.I'mg address, <br /> Generebrs P'nane: <br /> B.Transposer 1 Company Name U.S.EPA ID Number <br /> DEC 0 62016 <br /> 7.Transpoder2 Company Name U.S.EPA ID Number <br /> ^I1111g;i i- <br /> B.Designated FadNty Name and Site Address �I v <br /> L <br /> L ENV1KUvU.S.FPA ID Number <br /> Fal Phone: <br /> 98. 9b.U.S.DOT DescmyHon(including Proper Shipping Name,Hazard Class.ID Number. 10.Containers 11.Total 12.Unit 73.Waste Codes <br /> and Padang Gmdp(f any,) <br /> Hyl <br /> No. Type QuantityWUVaI. <br /> W � <br /> cad <br /> Z <br /> I HIS WASTE STREAM HAS BEEN <br /> FOR RE tin QUALIFIED <br /> ,r <br /> DeMEf•(,NO/KERDOON FACILITY IN COMPTON, <br /> CALIFORNIRF IFFIB;F A.THIS FACILITY HAS T <br /> x STE STREAM AS <br /> QUALIFIED.OUR EPA NUMBER AS CAT08 0 335 <br /> 18.Special Handling Instructions and Addiecnah informador <br /> 15. GENERATOR'SICFFEROR'S CERTIFICATION: 1 hereby declare that the currents of this consignment are My and accuietaly described above bxy`the proper shipping nam a.and are classified,packaged, <br /> marked and labeled7piasarded,and are ra'.I respects in proper condition he <br /> transport according to applicable intertsetlenaland national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I cenrfy,that the contents of this consignment conform to me terms of the attached EPAAcknowladgment;f Consent <br /> I sandy that the weeks minimization statement iderified in 40 CFR 28227(a)(JI am a large quamity generator,or Ib)pftend a small quanly enerator)is Imo. <br /> Ganera!aryO'erorsNdnledTyped Name Signature :T j Month Day Year <br /> J ?S.mannaecn I Shipnerts <br /> Z ❑ilmpat to U.S. ❑Export from U.S. t'Fortofentry/exit: <br /> Transporter agnalure('or exports only): k Date leaving U.S.: <br /> C ?T.Ts ranspMerAknowledgment or.Receipeof Mater!als - <br /> y, Transpoder 1°PmedRyoed Nene Signatcre Mo'T� Day Year <br /> n <br /> QTransporter PnntetliTypsd Name Signature blerlh Day Year <br /> oc <br /> t— <br /> 18.Discrepancy <br /> 1Be.Discrepancy Indication Space Quemoy ❑iype ❑Residue ElPartial Rejection ElFull Rejection <br /> Manifest Reference Numben <br /> 10b.Fdtemale Facility(or Generator) U.S.EPA ID Number c <br /> c <br /> U <br /> LL Fadidys Phone' <br /> W 180,Signatua of AlternateFaciliy ter Genemter) Month Day_ Year <br /> Q _ <br /> Z <br /> m19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and tecycfing systems) <br /> p ? 2. 3. x. <br /> l 20.Designa.y'Fadi y Ower or Operator:Certification of receipt of hanrclous materials covered by the manrfes except as mad In em 18a <br /> FnntedRviceC Name tignature s _ Monro Day Year <br /> r , <br /> EPA Form 8700-22(Rev.3.05j Previous edition;are obsolete. —via;G'INATEE FACILITY TC:GENEPATOR <br />