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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 CAD097068126 1 408-363-3678 019 415 4 4 3 JJK 5 r r' ili bV6bbCTS CORPORATION Generator's Site Address(if different than mailing address) 1412 EL PINAL D8 STOC?TON, OA 95205 Generator's Phone: 9111Q 46666—RQ94 6.Transporter 1 Company Name U.S.EPA ID Number ALL CLEAN HABA>BMUS WASTE REMOVAL INC CAD982492399 7.Transporter 2 Company Name U.S.EPA ID Number 8sa2i a anAddress U.S.EPA ID Number 88.51 DICE ROAD SANTA FE SPRINGS, CA 90670 Facility's Phone: 800-777-1850 CAD008488025 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 Wt./Vol. RQ7 UN INORGANIC, ,N_O-9r, 8, PG II (PHOSPHORIC ACID) � TP � O Z 2. W C? 3. 4. EF-i 141 peC 1du1nSytions aHPtn 4 OSHORICACID SOLU77ONc Y �93 "( 7,)Ci All PO# 14342-1 15, GENERATOR'SIOFFEROR'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 EPAAcknowledgment 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 s all quantity generator)is true, Generator's/Offeror's PrinteddlTyped Name Signature Month Day Year —j 16.International Shipments ❑Import to U.S. ❑Export fro S. Port of entry/exit: Transporter signature(for exports only): Date leaving U.S.: N_ 17.Transporter Acknowledgment of Receipt of Materials LLJ Transporter 1 PrttlTypod,'Name Signature Month Day Year 5- )� Z Transporter 2 Printed/Typed Name Signature Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type Residue El Rejection Fall Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J ii Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year Z 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 ncded in Item 18a PrintedlTyped Name Signature Month Day Year EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. F XITY TO EPA's ei-M NIFE T SYSTEM