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PIPa ndntor Nm tFnrmd..,Mfrsruseonellefl2.dtthIMewgter.) conn Approved. OMB No. 205M39 <br />EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. OE.'!GNATED FACILITY TE) DE5T;NzTi0N STATE (IF REQUIRED) <br />UNIFORM HAZARDOUS+1. <br />Generahv IDNumber <br />2Page l of <br />1 <br />3. Emngercy Response Phone <br />4. Manifest Tracking Numbar <br />015349530 JJK <br />WASTE MANIFEST <br />CAR000186668 <br />0 3� -4�7g <br />5. Geri New and Mwerg Addreas Gerevatoh Sue Address (dtldfe ent Nen maSing addrese) <br />COIMAlNITY FUELS 809-C 5NEDEKER Al E <br />809-C SNEDEKER AVE <br />STOCKTON C.A 9527E STOCKTON CA 9520° <br />Generatah Pho, 209466-4-323 <br />6. Transporter 1 Company Name U.S. EPA ID Number <br />VNIROSERY' CAR000188201 <br />7. Transporter 2 Company Name U.S. EPAID Number <br />6. Designated Faddy Name and Sde Address U.S. EPAID Number <br />CHEMCAL WASTE NANAGENIENT <br />55251 OLD SKYLINE RD. <br />KETTLEMAN CITY CA 913239 <br />Faatys Piens P•�)3W9717 ICAT000646117 <br />ge. <br />9b• U.S. DDT Description (iM.idrg Proper Shipping Name, Huard Case, ID Number, <br />10. Containers <br />11. Total <br />12 Unit <br />13. Waste Codes <br />No. <br />Type <br />W, <br />and Packing Gaupiifany)) <br />Ouantiy <br />WLNol. <br />dd <br />I. NON RCRA FIAZAROOU5 WASTE, LIQUID (GLYCER.4d, BIODIE5EL) <br />491 <br />0C, <br />r' nd <br />Z <<. <br />G <br />2' NON RCRA HAZARDOUS WA5TE, SOLID (DEBRI5, TRACE BIODIESELI <br />UJ <br />Qi <br />D, ht <br />_ <br />3. 116 ti , s <br />RIZ <br />4. <br />14. Spee at Handling seductions and Additional Inform" c <br />DM <br />961) CA6L>8930-GLYCERIN SLUDGE 5'YGS ERGdi:961. 17;962111 ••ER5W.O#172476-YA. <br />9621 CA6O9L128-DEBRIS-DRAINED FILTERS Ya'y OIL. BIODIE5ELIbX 'S, VW <br />2d Hfi ENERGENCY CONTACT. ENYIROSERY <br />SCERTFICATKIN: I Mrebydeclare mat the content of Ohs censipanerl are fly antl accunuey described above by Ne proper shipping name, and are dassifed, packagedd, <br />anda2 N Y respells in proper wrblion for tansnit according a applicable international and naWnal govemmenal regulations. If n¢at sNpment ark 1 em Ne Prmary <br />ac I wNy Nat d:e corlenfe of Na wncignrnent conform N tisarmsof fie atadsd EPAAc'vwMedgmentofConsenty <br />L <br />tiaf the wase rdnimvaE.atement.dwgeda40CFR262.27(a)(SIamaageema Utygene W)ortb)@Iemasmat..quanblygere Wr)bNie. <br />i0tterof6 PnnYdRy�d Name Sgnah MI y Year <br />C' <br />' <br />17A✓ � / <br />15. Inamatonal SNpmenls ❑HgorthoU.S ❑Exportkorn U.S. Pon of enty,'eot: <br />z <br />Trarspour signature (for export; only): Data learrg U.S-: <br />w <br />17. TrmpoUSAck ow, Jment of Receipt of hU'arials <br />TinsName 'e Monet Day Year <br />-�)PratedTyad <br />:r1�,I <br />J4b <br />Transporter 2 PhnledRyped Name sq m Monty Day Year <br />Q <br />16. DisaepancY <br />Its. Discrepancy lndiadon Spew ❑ Due,ty El Type El Residue ,)L.JPaeieI Rejecton El Furl Relectlon <br />O ZUIb <br />+- <br />Mandest Refe7ene Number. <br />Ile. Aneres Feaety (m Gemma.) ENumber <br />di`+.°iRONiVi�iV�LO <br />HFA!l � iFC)AfTMENT <br />LL <br />FaW'yh Phoned <br />16:. 5111 ofAlernaa Fadiy(orGenerator.) Monet Day lee <br />a <br />z <br />y19. <br />HarnNws Wass Report Maegernent Method Codes (.e., codes far ha7a-do s waste treatment, deposal, and recycling systems) <br />7 <br />1. <br />6,— <br />2. 3. <br />4. <br />20. Designated ' iy Oxer or OperSar. Cerh a0m of mwlpt of harardous matenals covered by the manifest except as in tam 18a <br />Pursed l/� , �410 <br />year <br />��.E • Signature /7 O2eleven il <br />EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. OE.'!GNATED FACILITY TE) DE5T;NzTi0N STATE (IF REQUIRED) <br />