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!ase print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 1.Generator ID Number 2.Pae 1 of 3.Emergency UNIFORM HAZARDOUS g rg cy Response Phone "'603732220 .Manifest Track^in�g�N]umberl� r� WASTE MANIFEST CAL00003590.1 'r .'�10-I�' O O� ( 3�2 2 O G B F 5.Generators Name and Mailing Address Generator's Site Address(if different than mailing address) TUFF BOY , INC. 5151 EALMONDWOOD DRIVE' Generator's Phonet pan2 1.-. MANTECA,CA 95337 6.Transporter 1 Comy Name U.S.EPA ID Number 7.Transporter 2 Company Name AMERICAN VALLEY WAST U.S.EPA 10 Number ASBURY ENVIRONMENIAL SERVICES 8.Designated Facility Name and Site Address U.S.EPA ID Number YUMA YES LLC AZRD00175422. 2730 E. I3Th ST YUMA, AZ 85385 Facilis Phone ga, go.U.S.OOT Deschplion(including Proper Shipping Name,Hazard Class,ID-Number, 10.Containers 11.Total 12.,Unit �,Waste Codes HM and Packing Group(f any)) No. Type Quantity WI.Nol. 1. NON-RCRA HAZARDOUS WASTE SOLID, ABSORBENTS&OIL 1 •qM ISO p 352 2. 3. 4. 14,Special Handling Instructions and Additional Information PROFILE#179715NRS ABSORBENT&OIL ERG#171 EMERGENCY CONTACT:JOSH d„ /n ��0�Q 15. GENERATOR'SIOFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment etre fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,and are In all respells 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 EPAAck nowtedgmenl or Consent. I cerilty that the waste minimization statement Identified In 40 CFR 26227(a)(If I am a large quantity generator)or(b)Cf I am a small ntity generator)Is tru . Generator'slORames PdnteWyped Name Signature Month Day Year }- P 17 1 1$ 16.Inlemational Shipments ❑Import to U.S. ❑Export from U.S. Port of entrylexiL' Transporter signature(for exports only): Date leaving U.S.: 17.Transporter Acknawledgmenl of Receipt of Mate s Transporter 1 P' to S MonI Y TrP6e ledlTyped Name Signatu Month Day Ye r 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection El Full Refection Manifest Reference Number. 18b.Alternate Facility(or Generator) U.S.EPA ID Number Facility's Phone: 18c.Signature ofAllemale Facility(or Generator) Month Day Year 19.Hazardous Waste Report Management Method Codes(.e.,codes for hazardous waste beatmenl,disposal,and recycling systems) 1. 2. 3. 4. 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Pdnled/Typed Name Signature Month Day Year ?onn 8700-22(Rev.M5) Previous editions are obsolete.