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Please print or type. Form Approved, OMB No. 2050-0039 <br /> UNIFORM HAZARDOUS 1 . Generator ID Number 2. Page 1;of 3. Emergency Response Phone 4. Manifest Tracking Number <br /> WASTE MANIFEST CAR 0 0 0 0 7 3 5 8 5 1 " (300) 424-9300 020380912 JJ K <br /> 5, Generator's Name and Mailing Address Generator's•SiteAddress (if different than mailing address) <br /> TRACY TOYOTA - NORTH NAGLEE RD <br /> 2895 NORTH NAGLEE ROAD <br /> TRACY CA 95376 <br /> Generator's Phone: 209 834-1111 <br /> 6. Transporter 1 Company Name U.S. EPA ID Number <br /> WORLD 01L '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 53 <br /> ga, 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 Wt.Noi. <br /> ' NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIL/MIXED OIL) 221 <br /> o <br /> DM P' G <br /> z 2* <br /> LU <br /> c9 <br /> 3. <br /> 4. r <br /> 14. Special Handling Instructions and Additional Information <br /> EMERGENCY CONTACT : CHEMTREC 1-800424-9300 WOES TERMINAL: CERES CS NAERG# 961 : 171 * PROFILE # 961 <br /> TRA07 &101419 USED OIL/MIXED OIL * * APPROPRIATE PPE EQUIPMENT � ,,-- <br /> 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classed, 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) (ifI am a small quantity generator) is true. <br /> enerator'slOfferor's Pnntedlryped Nam Signature Month Day Year <br /> 16. International Sfilpments <br /> t— ❑ Import to U.S. ❑ Export from U.S. Port of entry/exit: <br /> ? Transporter signature (for exports only): Date l9pving U.S.: <br /> j a 17. TransponerAcknowledgment of Receipt of Materials <br /> LU <br /> Transp r nnted(1yp Nam Signature Month Day Year <br /> ` <br /> I 9L �(` <br /> Transporter 2 Printed(ryped Nae Signature onth Day Year <br /> 18, Discrepancy <br /> 18a, Discrepancy Indication Space Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection <br /> Manifest Reference Number: <br /> 18b, Alternate Facility (or Generator) U.S. EPA ID Number <br /> CO) <br /> ta+- Facility's Phone: <br /> 18c. Signature of Alternate Facility (or Generator) Month Day Year <br /> LUQ <br /> Z <br /> 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> 0 9 2, 3. 4. <br /> i' 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a <br /> t <br /> Printed/Typed Name Signature Month Day Year <br /> r- � l►�c� � �'a. e5 Z <br /> EPA Form 8700-22 (Rev. 92-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />