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Please print or type. 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 CADB97058126 *400«.363-3 670 0 . 9 5 9 6056 JJ K 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) SUMIDEN WIRE PRODUCTS CORPORATIom :1412 ETA RINAL OR STOCKTON, CA 95205 Generator's Phone: 9 0 0 4 f,A-33 q 94 6.Transporter 1 Company Name U.S.EPA ID Number L CLE A. TF WASTEEI-MI7AL INC CAD962492399 7.Transporter 2 Company Name U.S.EPA ID Number ,ARRY RECYCLING, INC_ CA 000.19 21.7 8,Designated FaciliI Name and Site Address U.S.EPA ID Number E RRA TEIMRY DE MEXICO Faciliiy'sPhone: 619-270-9453 T c130619001 9a 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit No. HM and Packing Group(if any)) Type Quantity Wt.Nol, 13.Waste Codes 1. 3S2 Lm- 3. 4. 14.Special Handling Instructions and Additional Information 1) R19--25098 ILL SOLID � FRUMY EYRO e TEILWRY RECTC f INC- 020539/10E/:18, t� t RO# 14454 15, GENERATOR'S/OFFEROR'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 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 EPA Acknowledgment 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 l m a small quantity generator ' ue. Genera is/Offeror's Printed/Typed Na Signature �e Month Day Year 15 13/ 1 Z 16.International Shi nts F- ❑Import to U.S. 0 Export from 1 . ort of entry/exit: Z Transporter signature(for exports only): Date leaving U.S.: W- 17,Transporter Acknowledgment of Receipt of Materials LLJ Tra sporter 1 Printed/]]Typed Name Signature Month Day Year �R Transporter 2 Printed/Typed Name Signature Month Day Year e- I18.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 r U Facility's Phone: LU 18c.Signature of Alternate Facility(or Generator) Month Day Year B Z v) 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) � 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 Printed/Typed Name Signature Month Day Year EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. l #13 15 l -1� , yet t} y