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Please print or type.(Form designed for use on elite(12-pitch)typewrder.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1•Generator ID Number 2.Page 1 of 3 Emergency Response Phone a.Manifest Tracking Number WASTE MANIFEST C A L 0 0 0 3 4 1 1 7 9 1 424-M 015105346 6..Generator's Name and Mailing Address Generator's Site Address(it different than mailing address) WESTERN TRUCK CENTER WESTERN TRUCK CENTER PO BOX 32020 3333 S.HIGHWAY 39 STOCKTON CA 95213 STOCkCTON CA 95215 Generafurs Phone 8.Transporter 1 Company"Name m U.S.EPA ID Number ERE OU d ENVIRONMENTAL SERVICES INC C A R 0 0 0 1 7 1 0 1 7 7,Transporter 2 Company Name U.S.EPA ID Number WORLDWIDE RECOVERY SYSTEM INC S.Designated Facility Name and Site Address U.S,EPA 10 Number YUMA YES LLC 2730 E 13TH ST YUMA AZ 851365-1901 Fabll 's Phone. 3 A Z R 0 0 0 5 1 5 9 2 ga. 9b.U.S.DDT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13,Waste Codes Hit and Packing Group(if any)) No. Type Quantity wt Ncl. 1'NON-RCRA HAZARDOUS WASTE,SOLID(OILY DEBRIS, 223 a 0 190 r to t 4. 14,Special Handling Instructions and Additional Information )YES _Oily Debris .,, 444 -k�' 06'!� 11 Z— -9 Lo r�- -\ —C2 — Tt7 EE 40 3 AND USE PPE..ER Contud#205907 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;arc!are classifieed,packaged, marked and tabelediplacarded,and are in all respects tut 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 252.27(a)(if l am a large quantity generator)or(b)(If I am a small quantity generator)is true. General eg10ffercrs Printedttyped Name Signature — h Year -116.Intematitift Shipm nts F® ❑Import to U.S. Export from U.S. Port of entrytexit: 9 Transporter signature(for exports only), Date leaving U.S.:. Of 17.Transporter AcknmMadgment of Receipt of Materials Transporter 1 PrintedlTyped Namer" ! Signature Month ay Yearrss (j o n4 Z Transporter 2 Prin yped Name Signature Month Day Year I8.Discrepancy L 16a,Discrepancy Indication Space FI Quantity Type Res,duaej j ❑Partial R action ❑'Full Reaction Manifest Reference Number: 18b.alternate Facility(or Generator) U.S.EPA ID Number J 0 Facility"s Phone: LU 1 Sc.Signature of Alternate Facility(or Generator) Month Day Year 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) LU t. 2, 3. 4. 4111 1 20,Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 1S3 Prinledgyped ala a Signature Month Day Y ar XJ EPA Form 8700-22,(Rev,3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(IF REQUIRED)