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%T <br /> sip nt 0T type:(Form designed for use on e4e(12-pitch)typewriter.) Wit. = Farm Approved,OMB No.2050.0039 <br /> NIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 ofEmergency Response Phone 4.Manifest Trackin Number <br /> I OTE IMAM(FEST CA Lo 0 0 3 71213 1 rl'(80p) <br /> 424-9300 0.1 92477 JJ K <br /> �5.Gerierator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> GERTIFIED COLLISION,CENTER <br /> MO MURRAY DRiVE <br /> STuCA 95210 <br /> Generator's Phone: 209 530-9300 <br /> t 6.Transporfer 1 Company Name U.S.EPA ID Number <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> B.Designated Facility Name and Site Address U.S.EPA ID Number <br /> DEMENNO/KERDOQN <br /> 2000 N.ALAMEDA STREET <br /> COMPTON GPL 90222 O A T O 80013352 <br /> Facility's Phone: 131 QNK-q7-71 rin _ <br /> ga. 9h.U.S.DOT Dascripiion(including Proper Shipping Name,Hazafd Class,ID Number, 1B.Containers 11.Total 12.Unit <br /> 13.Waste Codes <br /> HM <br /> and Packing Group(if any)} No. Type Quantity wl.Nol, <br /> rr �/ 1 UN1993, FLAMMABLE LIQUID,N.O.S.,(PETROLEUM DISTILLATESy.' . .,. D001 D0]8 6.3f� PG II ' D M jC� G <br /> Z 2. <br /> LU <br /> i - <br /> 3. <br /> A. <br /> 14.Special Handing Instructions and Addltional Information r' <br /> EMERGENCY CONTACT,GHEMtREC 1-800-4249300 WOES TERMINAL:CERES GS PROFILE# 931,,.100417-04 PAINT � <br /> THIN14ER * k APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT <br /> / Af <br /> 15. GENERATOR151OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignmenl'are fully and accuratety described abov6bythe proper stipp'vrg name,and are classified,packageed <br /> marked and labeledfplacarded,and are In all respects in proper condition for transport according to applicable international and mlional govemmareA regulations.If amort shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of(he attached EPAAcknowledgme of C 1 <br /> I Vfy that 1h�waste minimization sl�temenl Idonlified in 40 CFR 262.27(a)(if I am a large quantity quantity ge ator)is true. <br /> G one or'sloffe ' PrintadlTyped't¢ame � ig ture Month Day Ypgr, <br /> 16.Intemalianal Shipments <br /> H ❑import to U.S. ❑Export from U.S. Po exit: <br /> Z Transpoiter signature(for exports only): us:i - <br /> LU <br /> 17.TransporterAcknowledgment of Receipt of Materials <br /> Transporfe7I PnntedlT ad Nae / SignaLxa Month Day Year <br /> CL <br /> cn <br /> Q Transporler2PrintedlTypedpame Signature (/ Month Day Year <br /> 18.Discrepancy <br /> 18a.Discrepancy Indica4on.Spaee ❑ Quantity ❑Type ❑Partial Re ❑Full Rejection <br /> ❑Residue jacfion <br /> Manilesl Reference Number: <br /> 1Bb.Altemate Facility(or Generator) U.S.EPA ID Number <br /> a <br /> U <br /> Fadlity's Phone: <br /> LL, 18c.Signature of Altemate Facility(or Generator) Month Day Year <br /> a1s <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,oodes for hazardous waste treatment,disposal,and recycling systems) <br /> LLI 1 r � 2. <br /> 20.Designated Facility Owner or Operator:Cerlfficatlon of receipt of hazardous materials covered by the manifest ex�eptascwWthiadterrrl8a <br /> Printed/Typed Name <br /> Signature '� Month, Day Year <br /> 1-4—y <br /> , fes. -- <br /> EPA Form 8700-22(Rev.3-05) PrevioUs)pditions are obsolete. DESIGNATED GENERATOR STATE (IF REQUIRED) <br />