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r A • a � a Phase print or type. (Form designed for use on elite (12•pitch) typewriter.) 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 I CAR 0 0 0 0 7 3 5 8 5 1 (800) 424-9300 017695261 JJ K 5, Generator's Name and Mailing Address Generator's Site Address (if different than malling address) TRACY TOYOTA - NORTH NAGLEE RD 2895 NORTH NAGLEE ROAD TRACY CA 95376 Generator's Phone: 209 834-1111 6. Transporter 1 Company Name U.S, EPA ID Number WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 7. Transporter 2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S, EPA ID Number WORLD OIL RECYCLING 2000 N . ALAMEDA STREET COMPTON CA 90222 C A 'i' O s 0 013 3 5 2 Facility's Phone: n y17. 71-no 9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers tt . Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type Quantity wLNol. 1 ' RQ, UN1993 , WASTE FLAMMABLE LiQUID , N , O .S . , (GASOLINE , DIESEL) D001 D018 343 . 3 , PG N DM G Z f 2. W C7 ' 3. 4. 14. Special Handling Instructions and Additional Information EMERGENCY CONTACT : CHEMTREC 1-800424.9300 WOES TERMINAL: CERES CS NAERG# 961 : 128 * PROFILE # 9131 : 460368 GASOLINE , DIESEL * * APPROPRIATE PPE EQUIPMENT 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 ail 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 EPAAcknowiedgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262,21(a) (if I am a large quantity generator) or (b) ( I n a ,; all quantity generator) is true. Generators/ Printed/Typed Name Sig ature Month Day Year d -Ito ar rte © zi 16, Intemall Shipme f- ❑ Import to U.S. 41 ❑ Export fro U.S. o of entry/exit: ti Transporter signature (for exports only): D leaving U.S.: W 17. TransporterAcknowledgment of Receipt of Materials Trans r 1 Printed/Typed Name Signature Month Day �Year � QTransporter 2 Printed/Typed Name Signature Month Day Year H 18, Discrepancy 18a, Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 18b. Alternate Facility (or Generator) U.S. EPA ID Number iJ U. Facilitys Phone: LU 18c. Signature of Alternate Facility (or Generator) Month Day Year d z 19. H z rdous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) G 1 . � a 124 3. 4. [7 - i 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printedlryped Name Signature Month Da Year I o hal a f es • EPA Form 8700-22 (Rev. 3.05) Previous editions are obsolete. DESIGNATED FACILI Y TO DESTINATION STATE (IF REQUIRED)