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Form roved,OMB No.265M039 <br /> Please print or type.(Form designed for Use on elite 02 Ett h)typewriter.) 1 of 3 Fz �Response Phone IAantfast Traclung Numbor <br /> UNIFORM HAZARDOUS 1""'torlDl,lumber <br /> 2.pap WASTE MANIFEST CAL000333052 1 (800 424-9300 <br /> 017695077 JJ <br /> 5.Generators Name and Marling Address Generator's Sika Address('d di SWA than maditlg Address) <br /> REEVE TRUCKING-REE006 ATT:SAFTEY DIRECT PO BOX 5126 5050 CARPENTER RD <br /> STOCKTON CA 95205 CA 95215 <br /> Generator's Phone: 209 940.2623 STOCKTON U.S.EPAID Number <br /> 8.Transporter 1 Company Name <br /> WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 9 6 <br /> U.S.EPA ID Number <br /> 7.Transporter 2 Company Name <br /> WORLDWIDE RECOVERY SYSTEM INC. CAR 0 0 01 7 5 4 2 2 <br /> U.Designated Facility Name and Site Address U.S.EPA ID Number <br /> YES MANAGEMENT. INC. <br /> 6500 US HIGHWAY 95 <br /> YUMA AZ 85365 A Z R 0 0 0 5 2 114 6 <br /> Facl][11 Is Phone: <br /> 9b.U.S.DOT Description(ncludng Proper Shipping Name.Hazard Class.ID Number, 10,Containers 11.Total 11 Unit 13.Waste Codes <br /> HM and Peeling Group In any)) No. TYPO INWd. <br /> - I'NON-RCRA HAZARDOUS WASTE SOLID(FLOOR SWEEP) CO <br /> ! DM �.5O P I <br /> LU 2'NON-RCRA HAZAROUS WASTE.SOLID(PAPER,FILTERS) 352 <br /> pM 3©� P <br /> 3. <br /> P <br /> 4. <br /> } <br /> 14.Special Handling hmsbuetions and Additional laformation 251 3X <br /> sJ <br /> EMERGENCY CONTACT:CHEMTREC 1-800.424-9300 WOES TERMINAL'CERES GS NAERG#961:171,9B2:171 *PROFILE# <br /> 951:162623NRS-REE008 FLOOR SWEEP,9132:162623 / OQ$ PER FILTERS " "APPROPRIATE PPE EQUIPMENT <br /> 15. GENERATOR'SiOFFEROR'S CERTIFICATION:1 herby declare that rhe cordaMs of this corss>grx wA are Rttllr and aaatrstely described above by the proper ahtpping name.and are dassised.packaged. <br /> marked and labeledlplacarded.and aro In all respects In proper conzon for transport according to applicable intemational and rnafi=l govemmental regulations.if export shipment and I am the Primary <br /> Exporter.I certify that the contents of this consignment cerdorm to the 101M of the abdhed EPAAdvim4odgment of Consent. <br /> I cu*that the waste minimization statement identified in 40 CFR 26227(a)N I am a large quantity genera mx(UMam a quaptity generator)is true. <br /> Gerherntors! s PrintedlT Signa Month Day Year <br /> t4 -!�� &� zvdzz�� <br /> J 16.international Shipments <br /> ❑import to U.S. ❑Export cram U.S. PoA o trylexit: <br /> Transporter signature(for exports only): Date leaving U.S.: <br /> W 17.Transporter AdvxRvtedg Hent of Receipt of Materials Monty day Year <br /> OTra or t Prirmtedlryped Norma � Srgnabmre /�/ <br /> Tran"2Pn Name Signature Month Day Year <br /> 18.Discrepancy <br /> 16a.Discrepancy Indication Space ❑ Quantity ❑Type El Residue ❑Partial Reject on ❑Full Re{ection <br /> Manifest Reference Number <br /> 16b.Allemate Facility(or Generator) U.S.EPAID Number <br /> J_ <br /> U <br /> F.Mys Phone: <br /> LOU 16c.Signature of Alternate Facility(or Generator) Month Day Year <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> O 1 2• 3. 4. <br /> V ( Ll <br /> 20.Designated Facility Owr*i or Operator.Certification of receipt of hazardous materials oavered by the manifest except as need in Item 16a <br /> Printedlryped Nameignaaue Month Day Year <br /> P0 (A C A 1UG -23 <br /> EPA Form 8706-22(Rev.3-0 ) Previous editions are obsolete. DESIdkATED FA L Y TO DESTINATION STATE(IF REQUIRED) <br />