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lead or type.(Farm designed for use on elite(12-pitch)typewriter) /FlgorMhnPApproved ONE No.2050-0039 <br /> UNIFORM WASTE MAN RDOUSEST 1.DmmmMm ID Number 2.Page 1 of 3.Emeriti fr 'hone <.Ma,0�3MT 4 138 G B F <br /> 5.Genesi Name and Mail',Add.. Dermal Site Monthly(If different Man mating addrema) <br /> GREEN VALLEY TRANSPORTATION CORP <br /> P.O.BOX 254 30131 HIGHWAY 33 <br /> Geremioh PM1 5385 <br /> VERNALIS,CA 9TRACY.CA 95304 <br /> 6.TUnspotlort Company Name US.EPAID Number <br /> AMERICAN VALLEY WASTE OIL, INC. CAR000272302 <br /> 7.Tamperer 2 Company Name US.EPAIDNumber <br /> WORLDWIDE RECOVERY SYSTEMS INC CAR000175422 <br /> 5.Devgnated Faintly Name aM Site Address US EPAID Number <br /> YUMA YES LLC AZR000516M <br /> 2730 E. 13TH ST <br /> YUMA,AZ 85385 <br /> Filaft y'e Ph.nd928d4Z 8168 <br /> 9p, %US,DOT Descin ,Onesdrg Pmper SNpping Name.Huard Class,ID Number 10.Conteirem 11.TOUT 12,that 13.Waste COWS <br /> HM aWPacking Gmup(Nany)) No. Tyra QuantityWtAted <br /> be 1' NON-RCRA HAZARDOUS WASTE SOLID,ABSORBENTS,PAPER OIL 2 DM 370 P 352 <br /> 1- FILTERS&DEBRIS <br /> de 2. <br /> ad <br /> u <br /> 3. <br /> 11,Special Handling lmoructlmsand Additional lnfrom ion <br /> PROFILE#183241NRS PAPERFILTERS ERG#171 <br /> EMERGENCY CONTACT: DAN <br /> 15, GENERVORTSKIFFEROR'SCERTIFICATION: I hereby catches Irate watered is wnsignmenl are fully and awumUlydascrbad above by Me pepershipping name.and are maiparagal <br /> markedaMismadlplararded,and are In all masedsIn popercell brbanspml awar0lr,M applicable Immora lentl lateral govemmental regulators.Nexpod shipmani l am Me Primary <br /> External,I car"et Me conUnh of Nis wnegnment wnr.rm UNe M.of Me atlacFed EPA Ackn.wledgmertof ComanL <br /> I worry Mat Me waste drlmattion aUlawatidentfieL in 40 CFR 262.27h)(N I em a Ieuard0y generator)or(b)(ill am a smell Mail generator)is We. <br /> GmaetolslONemh proodblTyped No. Signals. Day Year <br /> 16,International 3hipmerds <br /> ❑Imare,to U.S. ❑EMpwthom US. PotNenbyluit <br /> iranspreragnetore Mor expor6oMy)'. Oats kaving US.. <br /> w 17.Tmnsla Anmowladgmemdl pto Ma <br /> R Tmnaponttt PdntetlRyped Name SigrsW Nm9M Day rear <br /> S /[ O <br /> N <br /> G TUnsporer2 Pnone"ypad Nemo signal Memh Day Year <br /> r 5 <br /> 16.Dismepancy <br /> ,se.Discrepane,Indication Spew ❑ Ouentlty ❑Type ❑Mean. ❑Panel Rather., L1 Full Rejection <br /> Merifest Reemil Number: <br /> Ithe PlUmeU FecgNy(.r Carsratol US.EPA 10 Number <br /> U <br /> FadNps PMne. <br /> w FillLV ature MAtem"FadlNy(or Gelmal Nero Day Year <br /> z <br /> y19.HaexN.us Wast Repor Maregemenl MelM1od Codes 0.e.,mkea Mha]erWus waste trdhnent.disposal aM reryding symema) <br /> G 1. 2 4. <br /> 1 20 Deng l@m 10. <br /> gre <br /> Montym,malove mDay Y <br /> EPA Form 8700-22(Rev,3-05) Previous editors are obsolete. <br /> DESIGNATED FACILITYTO DESTINATION STATE (IF REQUIRED) <br />