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• 0 Please print or type.(Form designed for use on elite(12-pitch)typewriter.) For,Approved.0Iv1B No.2050-0099 UNIFORM HAZARDOUS 1,Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST I CALOOD384M 1 1^888-5xMO 8 � F L E 5 Generafers Name and Mailing Address Generators Site Address(V different than mailing address) Oda �Pki�Il�ed Feeds LLC 3ttodttm 1 �unF� 8Fi�06 Generator's Phone: riag W M .♦♦Tr2��l'19�00n�er__I�Ompany 2me �t V.S.EPA ID Number /sem Ador Ad 11�ut Inc. CAMWOM T.Trannporlur 2 Gompany Name U.S.EPA NuNumber �/`WR/ U.J.EYA IU Namher 8133 r� Itii�b=209W I MA 87107 Facility's Ph.. ga, 9b.US.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit MM and Packing Group(if any)) No. Type Quantity Wt Nol. 13.Waste Codes 1NON RGRA HAZARnous wA o ANU 5TE,SOLUM ENT f OM G P 3m i ?UN1210.w9ste Pfthg ilk 3.PG1 D001 0035 FM X I DIY- i 31 3, M ,. I I d. i 14,Speotal Handling Instructions and Additional Information 1) AGT47267 DCA- Dy/ /X s'S"c77� Prajwt Number 88838 DtYamelrt D103505 2)ERM21t ACM7288 DOA- c,Cz- i x 3 Z-7 07- 15 T15. GENERATOR'S(OFFEROR'S CERTIFICATION: I hereby declare that the4,ontents of this consignment are fully and accurately described above by the proper shipping name,and are dasai5ed,P—kag,d, marked and labele&placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am Vie Primary Exporter.I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is We. GtaeslOfferoen PrintadfTyped Name Ziqnature �r wntn Uoy yqor 16,International Shipments F- ❑Import to U.S. ❑E om U.S. Port of entry14 K Transporter signature for exports only): Date leaving U.S.: 17.Transporter Acknowledgment of Receipt of Materials ,~„ Tra rter 1 PrintedlTyped Name ig�G en ay ear EL Z Transporter 2 Printedlfyped Name Signature Month Day Year 16.Discrepancy 1 Ba.Discrepancy Indication Space ❑ I t'uii Ruction Quantity ❑Type ❑Residue Partial Re'ecfion Manifest Reference Number. 18b.Attcmate Facility(or Generator) U.S.EPA ID Number J_ V Faciti s Phone: W 18c Signature of Alternate Facility(or Generator) Monty Day Year 4 19 Hazardous Waste Report Management Method Cortes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) O 1 2. 3, 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item t 8a rOWF Name Signature Mon[ Day Year EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED)