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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page ge 1 of 3.Emergency Response Pnono A.Manifest Tracking Number WASTE MANIFEST CAL 0 0 0 3 3 7 2 7 6 @0(� 368-4778 016163479 JJ K 5 Generator's Name and Mailing Address Generator's Site Address(if dfferenl than malling address) PACIFIC ETHANOL STOCKTON LLC 9028 NAVY OR 3028 NAVY OR STOCKTON CA 95206 5TOCKTON CA 95206 Ganerators Phone: 209235-0370 6.Transporter'I Company Narne U.S EPA ID Number ENVIR05ERV CAR000188201 7 Transporter 2 Company Name. U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S,EPA ID Number U5 ECOLOGY HWY 95,12 MLE5 SOUTH BEATTY NY 59003 Facility's Phone: (� � N V T 3 3 0 01 0 0 0 0 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.Nol, 1. NON RCRA HAZARDOU5 WASTE,50LID(OIL, dEBR15) o D M F z w 0 14.Special Handling Instructions and Additional Information 9B110701283O0-8537-OILY SOLI05&DEBRIS �j�S' - ERGf1:9B1. iii *'ERS W.OIE 130449-ECB" 24 HR EMERGENCY CONTACT:EWIR05ERV 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 labeledlplacarded,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 stateme t identified in 40 CFR 262,27(a)(if I am a large quantity generator)or(b)(If I am a small quantity generator)is true. Geiie'' n`'sJof roes Printedl� a Nnm Signature Month Day Year YM~�� U"� 14w L` I R II Z (b 16.International Shipments 1 ❑Import to U.S. 1 Export from U.S. Port of entry/exit: Transporter signature(for exports only): a leaving U.S.: w 17.Transpo rAcknowledgment of Receipt of sterlals Transpor r Printed)Typed Na gnahrre M0111111 Day Year 0 lZ f o. r Z Transpo ted ype Name Signa re Mo Day Year 18,Discrepancy 18a.Discrepancy Indication Space I—I Quantity F--]Type ❑Residue Partial Rejection Full Rej ection Manifest Reference Number: 18b.Allernate Facility(or Gereralor) U:S.EPA ID Number J U rai I mlflty's Phone: Lo 18c.Signature ofAltemate Facility(or Generator) Month Day Year a Z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) G 1 � 2122 20.Designate Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PrintedlTyped Name Signature Mvnth bay Year Eev I'A Form 8700-22(R .3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE(I REQUIRED)