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Please print or type. 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 C-4,t�Gd�i .33655 v �, c . J�K 5.Generators Name and Mailing Address . Generators Site Address(if different than mailing address) RAI,-KIS Ehi'Vi1R.OMMENttTN3- P.0 00,1401 b1tE5'1'SACRAANIE.:NTO,CA '.':r._,633 Generator's PhonM1F.-n7 i:M'u.' 6.Transporter 1 Company Name U.S.EPA ID Number ;Imt�1 i Il,.ti?rjpJ4a3Eh(TEtI SERVICES INN. ' 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address - U.S.EPA ID Number -I 3S-l`7!`vli'?C ivfvtE:r4�'r L.SI':.R"ACES INC. i+tirv,nsnn �x 1-515 SOUTH RIt�Ft h20. ' ,�•,••�•,-,••'".."": f •NEST RACRAME.tNTO,CA $+6-QJ F Facility's Phone r'?:T 7 i-"i71 7 ga 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)) 13.Waste Codes No. Type Quantity Wt.Nol. I O 1. i;If.)iU ?l:tC.? I I�7RhI Crl t a WASTE LIQUID OJSED ANTIFREEZE)) Z 2. w 3. 4. 14.Special Handling Instructions and Additional Information r 981} USEDN11FREE�ERGOSM"I : E.R. CONTPACTOR: RAutAOS E0.'?RIONUIENTAL tiAf'1Dt-ERS:.,? CIUU D Rr=T aINE0 A€10 I}s;^PPR0V'ED F'•:r'i= 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 labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.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 identifie4 in 40 CFR 262.27(a)(it I am a large quantity generator)or(b)(if]am a small quantity generator)is true. Gene.ratoeslOfferoes Printedrryped Name ' 1 Signature r' Month Day Year 16.International Shipments , ZEl import to U.S. El Export from U.S. Port of entry/exit: " Transporter signature(for exports only): Date leaving U.S.: IX LU 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed[Typed Name !j3 Signature Month Day Year O d r'r! r ..s-n Ju7�=•i'L- 0.4'-�.•- .,..-'2 /'. r'r�� +'�i-1 %I(�� U) Transporter 2 Printed7Typed Name Signature Month Day Year r- 18.Discrepancy 18a.Discrepancy Indication Space ❑ Ouant I El Full Rejection ty El Residue Partial Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year f- a z 19,Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) p 1• 2. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noed in Item 18a Printed/Typed Name Signature ' Month Day 7Yefl 1 k :fr' t Ard ' �,yr?:- •3r' j'a. .1,V Ey = u EPA Form 8700-2 (Rev.12-17) Previous editions-afe obsolete. DESIGNATED FACILITY COPY IF YOU RECEIVED THIS MANIFEST,YOU HAVE RESPONSIBILITIES UNDER THE e-MANIFEST ACT.SEE INSTRUCTIONS ON REVERSIE SIDE.