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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phoneribels <br /> tTrackin Number <br /> WASTE MANIFEST CAD097068126 1 408-353-3678 9 15 4 4 2 JJ K <br /> 5.Generator's Name and Mailin Address Generator's Site Address(if different than mailing address) <br /> SU=EV WIRE PRODUCTS CORPORATION <br /> 1412 EL FINAL DR f <br /> STOCKTON, CA 95205 <br /> Generator's Phone: ?ft9 $�'ii—RQ?4 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> ALL. CLEAR HA$ARDOUS WASTE RE!MVAL INC CAD982492399 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> Vieesivieed�Facili NYameNakndVSite AdAdress U.S.EPA ID Number <br /> HWY- 9.5 11 ffiLES. SOUTH OF BEAT1Y, P .0_ WX 578 <br /> BMW, N9 89003 <br /> Facility's Phone: 775-553-2203 HM30010000 <br /> ga 9b.U.S,DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12,Unit <br /> HM <br /> and Packing Group(if any)) No. Type Quantity Wt./Vol. 13.Waste Codes <br /> 1.1952, a f s D002 D001 3491 <br /> INORGANIC, N_O_S., 8, PG—II (PHOSPHORIC ACID, <br /> E 8 <br /> OF 10 <br /> P <br /> Cg0 }. <br /> z 2. <br /> w <br /> 3. <br /> 4, <br /> 14.Special Handling Instructions and Additional Information <br /> 1) 070137709— 10734 PHOSPHORIC ACID SLUDGE dot r SCs � <br /> AIC PO# 14342 <br /> 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, <br /> 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 <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)(if I am a s all quantity generator)is true. <br /> Generator's/Offeror's Printed/Typed Name Signatu Month Day Year <br /> 16.International Shipments <br /> p- ❑Import to U.S. ❑Export from . . Port of entry/exit: <br /> Z Transporter signature(for exports only): Date leaving U.S.: <br /> w <br /> 17.TransporterAcknowledgment of Receipt of Materials <br /> I& Transporter 1 Print /Ty ed Name Signature Month Day Year <br /> O <br /> d <br /> z Transporter 2 Printed/Typed Name Signature Month Day Year <br /> H <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space ❑ Quantityyp j t <br /> ❑Type El Partial Rejection El Re'ection <br /> Manifest Reference Number: <br /> t>- 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> J_ <br /> V <br /> LL. Facility's Phone: <br /> w Year <br /> 18c.Signature of Alternate Facility(or Generator) Month Day , <br /> Z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 1. 2. 3. 4. <br /> 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> Printed/Typed Name Signature Month Day Year <br /> EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. !0E 5iGA T ED FACILITY TO EPA's A.-MANIFEST SYSTEM <br />