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Please print or-type.(Form designed for use on elite(12-pitch}typewriter.) Form Approved,OMB No.2050-0039 UNIFORM HAZARDOUS I.Generator ID Number 2.Page 1 of 3 Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CAD9830iTr�,=�'� 1 yl]�.4i':s1-rS71�+ op .i ; 1 �� ;� i4 G B F 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) ASSOCIATED TRACTOR SERVILE, Il 1312:1 V+l 1'HAA TER INA;' Si IOC K I'ON,CA. 852(1_, Generator's Phoner f' _ tlrl' ; 6.Transporter 1 Company Name U.S.EPA ID Number Afvii:RiGAi,' VALL .1 'rVAIi31OIL. INC:. CAI OQU272302 7 Transporter 2 Company Name U.S.EPA ID Number 01ORLDVIVIJ. CFiyttS{Jt3 i Th410 8 Designated Facility Name and Site Address U.S.EPA ID Number i'L'i:!Fk 'r X 7 LLC; '730 E :yTH 87 A.R000I754.X� `f UIOPP,AZ 1`.1.5 305 Facility's Phone;JJ!6-042-•E 938 ga 9b.U.S.OOT Description(including Proper Shipping Name,Hazard Class,ID Number, 0.Containers 11.Total 12 Unit HM and Packing Group(if any}) 13.Waste Codes No. Type Quantity WLNoL 1. ccy Q ('110;'�-RC RA HALAR!]OLRl;WASTF SOL(1.3,AB&)R R1 l::. -t? 7'' i Lu r LU2. ra f 4. 17-1— i I 14.Special}candling Instructions and Addltional Information PRut-II-El I (fir P 014ERGI fitC X l:(?r•!i'ACi': SAAR J . 15, GENERATOR'S10FFEROR'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 labeled/placarded,and are in all respects in proper condition for transport according to applicable internalional and national governmental reguiaUons.If export shipment and I 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 quantity generator)or(b)(if I am a small quantity ge,•ierator)is true. Generaslero s Printedffyped Name Signatart5) i` 1 Month Day Year f, , � 18.International Shipments � ❑Impart to U.S. ❑Export from U.S. Port of entry/exit: Transporter signature(for exports only): Date leaving U.S., UW 17.Transporter Acknowledgment of Receipt of Materials WTransportere P' e a O 1g ' 9 ntGre Monthi Day Yea CL QTra riar 2 Prjntedfl yped Name onth Day ea �_7 — 18a.Discre ancy Indication Space El ❑ Quantity ❑Type Resio'ue - ❑partial Rejection El Full Rejection h4anifest Reference Number: 18b.Alternate Facility for Generator) U.S.EPA ID Number J U Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year a Z N19.Hazardous Waste Report Management Method Codes(i,e.,codes for hazardous waste treatment,disposal,and recycling systems) UJI t 2. 20.Designated Facility owner or Operator:Certification of receipt of hazardous materials covered by the manifest excephas noted in Ilem 18a PdntedlType Name Signature Month Day Year it o EPA Farm 8700-22(Rev.3-05) Previous editions are obsolete.