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Please Drinlarypa.(Farm Basi sed bruse on elite(122pitah)typewnter.) Form Approved OMBNo.205HOS) <br /> UNIFORM NA2ARDO a' 1.Generator 10—N umber 2.Paget of 3.Smarten,Response Phone 4.Manlleat Tracklag Number <br /> WASTE MANIFEST CAL000430494 1 (800)4249300 017696308 JJK <br /> 5.Generators Name end Malling Address Geremtofe Sia Atltlmsa littlixerenl rhes mellinA adtlress) <br /> CALIFORNIAAUTOSPORT <br /> 180 BUTTON AVE <br /> MANTECA CA 95336 <br /> Genemafa <br /> pPhone: los 6657247 <br /> fi.Tranosm i Company Name U.S.EPA ID Number <br /> WORLD OIL ENVIRONMENTAL SERVICES CAD028277036 <br /> ].Tmnsponer2 Company Name U.S.EPAID Number <br /> WORLDWIDE RECOVERY SYSTEM INC. CAR 0 0 0175422 <br /> &[sregoehd Facility Nameand Sere Address U.S.EPA IO Number <br /> YUMA YES LLC <br /> 2730 E 13TH ST <br /> YUMA AZ 85365 AZR000515924 <br /> Fadllya pMre: 928 3449828 <br /> ga. 9b.LLG.DOT Daspipuw(ir�duding Proper SNppe"Name,Need Class,ID Number, 10.Conlainerb 11.Total 12.Unit 1J,WdBtB L0de3 <br /> HM and Packing GmW(ilany)) No. Type Oaamfty voters. <br /> z 1 NOWIFIZ HAMRDOUS WASTE,SOLID(OILY SOLID,PAPER FILTERS) �y� 352 _ <br /> DM /J ✓ P <br /> i 2 <br /> w — <br /> cg <br /> 3. <br /> 4. <br /> 14.Spider Handling tell ens andirri lInternalion <br /> EMERGENCY CONTACT:CHEMTREC 1-8004249300 WOES TERMINAL:CERES CS *PROFILE p SIBS:162623NRSCAL1109 <br /> OILYtk Io PAPER fl * *APPROPRIATE PPE EQUIPMENT Tfz-v/ <br /> 15. GENERATOR-WIFFERORSCERTIFICATION: IM1erebytledaretFal Ne comms oltNscereigmmemarelNly aM acuumlelydesmbed above by the proper ahipDing name,eN areDassiAed packaged, <br /> marked ed labgedryWcardeb,and are M au relertre in proper wmaw fte canal eawding be serious inlemmanmantl nslbnd governmental regulations.IfexpertsMpmwlandlam Ne Phmary <br /> Exposer,Icedifyttaltne wntenM oltblswregnmentwnkrm tDNe Urms Mtneedaabetl EPAAskno*Mtlgmentol Convent. <br /> cealytM1tl PoewasM maimizaligl eaamenl ae atl In 40CPR28R.21(a)pllemaMrge Wentiygererelop ) asmau Duenbrygerarelar)is Vue. <br /> GerereloralONames thin Typed Name x9n Worth Day Year <br /> x 11 u is iz <br /> 15. ntemetbhwarepmema ❑Imwsb U.S. ❑Ermoslrom UG. Fon ederawlexle. <br /> Transporter sgnetere(fit expods amy): Use leaving US.: <br /> w17.ThampndefAckw.Nedgmem of Raceipl of MakealS <br /> �. MaM Day Year <br /> Tram marl PdmkdRypletl Nain 9gn <br /> 2 The U Print Nam - / P" !� t areSg M� Dam A <br /> ear <br /> K t ✓l 7 U <br /> F <br /> }I tu.Dlsaepaixy <br /> 13s.Uieaapal trial Space ❑ Uuanuy ❑Type ❑ReaMue ❑Parcel Rejacllm ❑Full Relecten <br /> ' F Mant(eat Raarenm Number: <br /> Sub,Altemale i b,Genarear) ILS.EFAID Number <br /> V <br /> LL Fairies Phone: <br /> [Qyp i&. g <br /> Sndram mAlarrake Fedllty(or mal la Doth Day Yeer <br /> N 19.H838rtl0115 YVaSe Repan MB089emenl Methptl CDde3(LB.,wdeS NOl n83Brd0e4 Wa818 VeaVllent.dap0331,and raeytl'ng ey918ms) <br /> C 12. 3, <br /> 2tl.D88gmated ty DNAer DI DDSRIOr:Dellflw110n DIRCeDIDf 19EBrdDYa meMfae COVefld hydra memNe81&replfi90detl In Mm lSa <br /> 1 rm8 n K wt 8y BBI <br /> EPA Form 870022(Rev.3.05) PFivious editions are barrel DIISIGNATEDIFACUDY TO DESTINATION STAT (IF REQUIRED) <br />