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Please print or type. Form Approved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2,Page 1 o1 3.Emergency Response Phone 4.Manifest Tracking Number <br /> WASTE MANIFEST CAROW078204 1 1 888-785-7225 013305373 F L E <br /> 5.Generator's Name and MailingAddress Generato's Site Address(if different than mailing address) <br /> Califomia Natural roducts <br /> 1250 E. Lathrop Road ashlynn.amin@cnp.com <br /> Lathrop, CA 85330 <br /> Generator's Phone: <br /> bbc�t% ornece t1pll mical Transport IncJDBA ACTen%ir0 U.S.EPA ID Number CAR000070540 <br /> 7 ftsif Vl2t Kt'GomV {y SySt Inc U.S.EPA ID Number <br /> CAR000175422 <br /> 8.=d Facility Name and Site Address U.S.EPA 0Number <br /> Yuma YES, LLC AZR000515ta24 <br /> 2730 E. 13th St <br /> Yuma, AZ 85365 <br /> Facility's Phone: 928-3"-QB28 <br /> ga 9b.U.S.DOT Description{including Proper Shipping Name,Hazard Crass,ID Number, 10.Containers 11 Total 12.Unit <br /> HM and Packing Group(it any)) No. Type Quantity Wt.1Vol. 13.Waste Codes <br /> Mon-RURA Hazardous Waste,liquid, (Latex paint) DIVI p 1 <br /> 35a <br /> LU 2. on- Hazardous Waste Liquid, filters not crushed F 22 <br /> and Oily debris) <br /> 1 k�- <br /> 3. l�o+> - l�ir, oc,y Wa~k�. „t► ke,.�.,� l5 <br /> 4. <br /> 14,Special H Wing Instructions and Additional Information Project Number 2 current k 0289934 <br /> 7.1176707 CAY SAA SS (0:>J -09) ��+m��� �A>,+ a x � 0 _17 <br /> 2)/174460 CAY-_kk-2�!JA I is (0,,9 <br /> 15. GENERATOR'SfOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,arta are classified,packaged, <br /> marked and labeledlplacarded,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 EPA Acknowledgment 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)(ifl am a sigall quantity generator)is true. <br /> GeenyneralorslOfferors PrtyV N Signature Month Day Year <br /> `\ ? —� 3 � <br /> J 16.Inlemati0al Shipments <br /> Import to U.S. ❑Export from U.S. Port of entry! <br /> ? Transporter signature(for exports only); Date leaving U.S.: <br /> W 17.Transporter Acknowledgment of Receipt of Materials <br /> LLJ <br /> Transporter 1 Printed/Typed Name Signature Month Day Year <br /> a <br /> z Transporter Prinledrfyped Name Signature Month Day Year <br /> t^ <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residuej } <br /> ❑Partial Rejection Full Rejection <br /> Manifest Reference Number: <br /> 18b.Alternate facility(or Generator) U.S.EPA ID Number <br /> J <br /> U <br /> LL <br /> Facility's Phone: <br /> w 18c.Signature of Alternate Facility(or Generator) Month Day Year <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> c 1. T <br /> 3. 4, <br /> 1 <br /> 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as Holed in Item 18a <br /> 77p97Name Signature Month Day Year <br /> EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />