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ase print or type. (Form designed for use on elite (12-pitch) typewriter.) NEEMEN 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 t' tat G 0 0 '10 :3 7 7 t) 2 tBiiUy �<� a:�1i J J K 5. GeneraiiVs Name n Malligg Address Generators Site Address (if different than mailing address) . i " it � l , l : f t. i i ! t: WING . INC I78bl) Sf }fI1H IDEA[ PARYWAY MANTECA CA 953 :.1; ej Generators Phone; 6. Transporter 1 Company Name U.S. EPA ID Number � 4 ; � i'rYICE� , , , . , . 7, Transporter 2 Company Name U.S. EPA ID Number 8. Designated Facilityty JII .Name and Site Address U .S. EPA ID Number znM N A"EmDA '?Tf?f. FT Cfil'�ii'Tt?N f ;{� 9i) to A wI ct rl 0 0 13 3 5 Facilitys Phone: 9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10, Containers 11 . Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type Quantity WVVol. 1 . 1;q. IIrI = : W : . ir:9rol�lF: IW)IIII ' if) I FXJ1.4 ;� . , r' '�3A.�e7CII'Ji- �l]�IE r: 1 _; :1 , rfalf RIEC 3. 4. wo EP E�lVIR® P\�� EN ® 14. Special Handling Instructions and Additional Information FMFF1t3E14f;Y (XtNTACT I IE MTRCC Cr RFS CS NACRG* %% 1 ' 128 ' PROF1I F R CL09 At I .641 . 1W2410 1 ;.A90I INF/01FONFL k 6 APMPRIATF PPF FQf7IPRr F' MT 15. GENERATOR'SIOFFEROR'S CERTIFICATION ; I hereby declare that the contents Df this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and labelediplacarded , 94are in all 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 EPAAcknoxtedgment of Consent, I certify that the waste minimization statement identified In 40 CFR 262.27(a) (If I am a large quantity generator) or (b) (if I am a small quantity generator) is true. Generator'slOfferots Printedfryped Name Signature Month Day Year i 16. International.Shipments ❑ Import to U .S. ❑ Export from U .S. Port of entryfexit: Transporter signature (for exports only): Date leaving U.S.: 17. TransporterAclmowledgment of Receipt of Materials Transporter 1 Printedffyped Name Signature Month Day Year 1 Transporter 2 Printed/Typed Name Signature Month Day Year 18, Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number. 18b, Allemate Faculty (or Generator) U.S. EPA ID Number i i Facilitys Phone: j 18c. Signature of Alternate Facility (or Generator) Month Day Year C 19, Hazardous Waste Report Management Method Codes (Le., codes for hazardous waste treatment, disposal, and recycling systems) ENRON 1 2 3, 4. 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PrintedrTyped Name Signature Month Day Year 'A Form 8700-22 (Rev. 3.05) Previous editions are obsolete, GENERATOR' S INITIAL COPY