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046581-20 3858776 <br /> Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page i of 3,Emergency Response Phone4.Manifest Tracking Number <br /> WASTE MANIFE CADOgglegou 00 0 3112 8 3 DAT <br /> 5.Generators Name and Mailing Address Generator's SI1eAddress(if different than mailing address) <br /> Applied Aerospace Structure Applied Aerospace Structure <br /> P.O. lox 6199 3437 SO. AIRPORT WAY <br /> Generator's Phone; Stockton GR 95296 12091903-33391 <br /> 6.Transporter 1 Company Name U,S.EPA ID Number <br /> STERICYCLE SPECIALTY WASTE 5CLUT M <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> B.Designated Facility Name and Site Address U.S.EPA ID Number <br /> 21ST CENTURY ERVIRO1EWIRL MNflGEhlENT OF (NEVADA, LLC <br /> 2995 kvlands Drive East <br /> Facility's Phone: FERNLEY NV 99408 (775) 575-2750 NVD980895338 <br /> 9a, 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10,Containers 11.Total 12.Unit <br /> 13.Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity W(.Nol, <br /> 1, NON-RCRA HAZARDOUS UASTE, LIQUID (OIL I DATER) 331 <br /> CK 01 im 43 P <br /> LU z UN2926 WASTE FLAIff(AILE SOLIDS, TOXIC, ORGANIC, H.O.S. (DEIRIS C! DAO1 >iRl7 DO35 <br /> X ACETONE, CHRUNI(A41 4..1 (6.1) P6ll 1101(1801) Dn P <br /> r FIOJ FOOS 352 <br /> 3. HON-RCRA HAZARDOUS WASTE, SOLID (CARBON FUER, EPDXY RESIN) 331 <br /> 03 DM P <br /> 4, NODI-RCflR HAZARDOUS WASTE, SOLID (PLASTIC, ADHESIVE) 352 <br /> 03 DCI P <br /> 14,Special Handling Instructions and Additional Information J <br /> (l) 909.435-02 - OIL I WATER (2) 6R1911-10 - ER611130 SOLVENT UIPES (3) 686733-09 - GRAPHITE PRE-PRE6 (4) GR3183-09 - <br /> FILM ADHESIVE <br /> 15, GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,ant are classified,packaged, <br /> marked,and labeled/placarded,and are in all respects in proper condition for transport according to applicable Intematlonaland national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. <br /> I certify that the waste minimization statement identified In 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(ifl am a s ail quantity generator)Is(rue, <br /> GeneratoeslOfferor's Printed/Typed Name Signature Month {Jay Year <br /> _j 116.International Shipments <br /> F„- ❑Import to U.S. ❑Expo ort o ntrylexit: <br /> z Transporter signature(for exports only): IeavingU.S.: <br /> W 17.Transporter Acknowledgment of Receipt of Materials <br /> w <br /> Tran oder 1 Printed/Typed Nam Signa Month Day Year <br /> O L C <br /> 0. <br /> aa Tra p rter PfintedlTyped Nam Signaturell Month Day Year <br /> c>C <br /> r- <br /> 18.Olscrepancy <br /> 18a.Discrepancy indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest Reference Number: <br /> 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> t� <br /> LL Facilitys Phone: <br /> La 18c.Signature ofAllemate Facility(or Generator) Month Day Year <br /> a <br /> Z <br /> N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> © 1. 2. 3. <br /> 20.Designated Facility Owner or Operator:Codification 4. <br /> ion of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> PrinledlTypad Name Signature Month Day Year <br /> EPA Form 8700-22(Rev.12-17) Previous editions are obsolete, DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />