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Please print of type.(Form Oe5igncd for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Nwrkr 2.Pago 1 of 3.Ernerq�ncy Rospanse Rhone A.ManlfoA Tracking Numbar <br /> WASTE MANIFEST CAD 9 81 9 6 7 6 8 0 1 (8UE)424-9300 017 7 9 2 011 J J K <br /> S.Gan@ d]��]f�qqq�[�5 g, — T TT TT r anereloeir SltaAddrass(irdiffamnl Than mairug addrrs) <br /> ar'nf i NTT �.11J6d9 Nb <br /> 3333 AUTO CENTER CIRCLE <br /> STOCKTON CA 95212 <br /> Cenuator'sPlwnc: 209 H77-3bb$ <br /> 6.Tram T Cr ' Naroa U-S-FPA ID�Iu bar <br /> ASBURY ENVIRONMENTAL MENTAL SERVICES C A U�'�8 2 7 7 0 3 6 <br /> ...... .............................................._._...........__._ <br /> i.Transportor 2 Company Name U.S.EPA 10 Number <br /> B.DesIEMEryryNNO/KERDOty Name and Silo OH <br /> 22ated s U.S.EPA ID Number <br /> B 000 N.ALAMEDA STREET <br /> COMPTON CA 90222 CAT080013352 <br /> FadtilysPhone: (310)537-7100 <br /> go. 9b.U.S.DOT Description(induding Proper Shipping Name,Hazard Class,ID Number, 10.Containers 10otal 12.Unit <br /> 13.Waste Codes <br /> HM and Packing Group(d any)) No. Type Quantity WL/Vol. <br /> ce 1UN1993,WASTE FLAMMABLE WASTE LIQUID,N.O.S.,(DIESEL, ? D001 D018 343 <br /> ce GASOLINE),3,PG II DM LJ G <br /> 7: 2, <br /> w <br /> 4. <br /> C7 <br /> 3. <br /> 14.Special Handling Instructions and Additional Information <br /> EMERGENCY CONTACT:CHEMTREC 1-SM424-9300 WOES TERMINAL:CERES CS *PROFILE#9B1:051817=04 DIESEL, ' <br /> GASOLINE * *APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT <br /> 16. GERE RATOR'SrOFFEROR'S CERTIFICATION:I horeby derb re W the contents of this coaalgriment aro fully and acoum tydow•bod above by the prnpar rhlpping name,and are classified,packaged, <br /> marked and labetedlplacarded,and are In al respects In.proper condition for transport according to appllwbla kdomablat and ma onal govemmontal rogubationa,If axpml shipment and I em the Primary <br /> Exporter,I certl[y that the cvntonts of this cowignmant conform to the terms of the attached EPAAda*wW t <br /> I cwhly that the m <br /> waste minlmlzetlon mataont Identified In 40 CFR 282.27(a)(it f am a Imga quantity gene rn a a quor*generator)is we. <br /> ocriamlor' fferors PrkAwryped Nome 51gna ro Month Day e <br /> --1 16.IntemiiWlW Shipm+ w <br /> I; ❑Import to U.S. ❑Export from U.S, Pwtol entry/exit <br /> ? Transfaxtor slgrrawre(fiat exports only): hate leaving U-S.., <br /> 17.TrvaprlerA*r*M p wnl of Rocelpt of Materials <br /> Tranu,000 1 PelntedfTypad Slgna4Vre { D <br /> Ck- <br /> - c^ <br /> 7ransponor 2 Pnnled/Typed Noma Signalure Montle DAy Year <br /> r� <br /> 1B.Discrepancy <br /> 18a.Discrepancy Indication Space- '❑ Quangty, ❑Type ❑Residue ❑Partial Rejection ❑Full Re)ection <br /> Manifest Reference Number. <br /> 185,Allomalo Facility(or Generator) U.S.EPA ID Number <br /> ci <br /> Fadtity's Phone: <br /> W 18c.Signature of Allomale Facility(or Generator) Month Day Year <br /> Q <br /> z <br /> 191 Hazardous Wasle Reporl Management Method Codos(I.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 0 1. 7 3. 4. <br /> 20.Dosgnated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as nded In Item 18a <br /> Printed/rypod Naino Signature Month Day Year <br /> EPA Ftxrm 8700-22(Rev.3-05) Previous editions are obsolete. <br /> DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED) <br />