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Please print or type. Form Approved. OMB No. 2050-0039 <br /> UNIFORM HAZARDOUS Ist . Generator ID Number 2. Page i of 3. Emergency Response Phone 4, Manifest Tracking Number <br /> WASTE MANIFEST CAR 0 0 0 0 7 3 5 8 5 1 (800) 424-9300 020380910 JJ K <br /> 5. Generator's Name and Mailing Address Generator's Site Address (if different than mailing address) <br /> TRACY TOYOTA — NORTH NAGLEE RD <br /> 2895 NORTH NAGLEE ROAD <br /> TRACY CA 95376 <br /> Generator's Phone: 209 83447.11 <br /> 6. Transporter 1 Company Name • U.S. EPA ID Number <br /> WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7, Transporter 2 Company Name U.S. EPA ID Number <br /> 8. Designated Facility Name and Site Address U.S. EPA ID Number <br /> WORLD OIL RECYCLING <br /> 2000 N . ALAMEDA STREET <br /> COMPTON CA 90222 CAT 0 80013352 <br /> Facility's Phone: (, 1 _ 1 QQ <br /> 9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10, Containers 11 . Total 12• Unit 13, Waste Codes <br /> HM and Packing Group (if any)) No. Type Quantity WtivoI. <br /> x 1 'RQ, UN1993 , WASTE FLAMMABLE LIQUID; N . O.S. , (GASOLINE, DIESEL) D001 DO18 343 <br /> 3, PG 11 ! DM G <br /> Lid 2s <br /> UJ <br /> t7 <br /> 3. <br /> 4. <br /> NOWNININNIN <br /> 14. Special Handling instructions and Additional Information <br /> EMERGENCY CONTACT : CHEMTREC 1-800424-9300 WOES TERMINAL: CERES CS NAERG# 981 : 128 * PROFILE # 9131 : <br /> 436830 GASOLINE , DIESEL * * APPROPRIATE PPE EQUIPMENT %I G 2© Lg / X � ) <br /> 15. GENERATORWOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, arca are classified, packaged, <br /> 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 <br /> Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment 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) (if I am a small quantity generator) is true. <br /> Generators/Offeror's Printed/Typed Name Signature Month Day . Year <br /> 16 <br /> 6. International Shipments <br /> IBM ❑ Import to U.S. ❑ Export from U.S. Port of entry/exit: <br /> ? Transporter signature (for exports only): Date le g U.S.: <br /> W 17. TransporterAcknowledgment of Receipt of Materials <br /> Trans p anted(fype Name Signature Month Day Year <br /> a <br /> Z Transp r 2 Printed/ryped Narrsk Signature Month Day Year <br /> h <br /> 18. Discrepancy <br /> 18a• Discrepancy Indication Space EJ Quantity 1:1Type ElResidue ElPartial Rejection ❑ Full Rejection <br /> Manifest Reference Number. <br /> 18b, Alternate Facility (or Generator) U.S. EPA ID Number <br /> U <br /> uQ. Facility's Phone: <br /> w 18c. Signature of Alternate Facility (or Generator) Month Day Year <br /> a <br /> z <br /> 19. Hazardous as Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> fn <br /> UJ <br /> i 2. 3. 4. <br /> 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> Printedfryped Name Signature Month Day Year <br /> X145 0 Z <br /> EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e- MANIFEST SYSTEM <br />