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Please print or..type.(Forth designed for use on elite(12•pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST uAD983t --tO-m i a ,�+. ?s it G B F 5-Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) ASSOCtAI-C:B TRACTOR SERVICE, iNC 132'1 VV''HJLMR I'E R WAY ST rOC K I text, CA 9520x-' Generator's Phon . :,•_.[F _'t ItJ" ,!� 6,Transporter 1 Company Name U.S.EPA ID Number AtviL-RiG'i VVASTI_OIL. INC. CAR1JG'lJ27Z502 7.Transporter 2 Company Name U.S.EPA ID Number VV1)RLDVV!l:=f•;Et:UI EI1Y --Y,�'I r-tv4-1;N,K, CICIRD00 i lh� 8.Designated Facility Name and Site Address U.S.EPA IO Number 1 LkafEti ;r,� kt_U: 750E ':Ti-i-' A'_RfICJl;17r-4. (lJfvls`, _ Facility's PhoneQ6-CiQ-8ANI, 9a 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(if any)) No. Type Quantity Wt.Nol- 13.Waste Codes 1. P1f:i�1 liC:nA 1 tA7RFZt]CiIJ`;+J:A:_T r 'i34-ll�,?�Ei ,r)Ft9E:llt I! ill til. r 3.62 i ur z 2. LU 0 4. E 14.Special Hardling Instructions and Additional Information AMSOIRBEr6;f'-i. ON FRC:: 177 E�h,1E=FtrE,t,lr�-y'f.'.�'tt#-rACi`: SAAF1 _ 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,and are classified,packaged, marked and labeiedlplacarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and 1 am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a){if I am a large quanlity generator]or(b)(if I am a small quantity generator)is true. Genera Werors PrinfedlTyped Name Signatvrt-) ; ` - Month Day Year , ! 1 C__ 16.Intemational Shipments z ❑Impart 10 U.S. ❑Export from U.S. Port of entrylexil: Transporter signature(for exports only): Date leaving U.S.: Li 17.Transporter Acknowledgment of Receipt of Materials X Transportere ?' _ O � /f $ r /'= ; /ry ✓ 9nalGre .�: s' �_ ,...... __. N Month, Day Yea C11- Q rier 2 PrintedlTyped Name onlh Day ea f 18a.Disc re ancy Indication Space ❑ Qua ❑ ntity ❑TyAa Residue ❑Partial Rejection ❑Full Rejection hlahfest Reference Number: 181b.Alternate Facility(or Generator) U.S.EPA ID Number J_ U LL FacNly's Phone: N16c,Signature of Alternate Facility(or Generator) Month Day Year a Z y19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) LLI 1 2. 3 4, 20.Designated Facility Owner or Operator,Certification of receipt of hazardous materials covered by the manifest excepl.as noted in I€em 18a PrintedlType Name_ Signature Mon h pay. ear l_..� =�`_ EPA Farm 8700- 2(Rev.3-05} Previous editions are obsolete. I