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ou � 3 <br /> Please plint or type,{Fong designed for use on elite(12-ptch)typevvnilor,) Form Approved,01VI8 No.2050-0039 <br /> I <br /> L209-825-02007,32r <br /> 299 Go <br /> UNIFORM HAZARDOUS 1,Generator ID Number of 3 Emergency Resrx Tracking Number <br /> WASTE MANIFEST CAL000381216 <br /> 5 GenisfatoeS Name and Mailing Addre%I L US MOWER&SAW Gewratoes Site Address(if different than mailing address) <br /> 852 N. MAIN ST <br /> MANTECA,CA 95338 <br /> 09-825-0200 <br /> Gerimatot's Phone:2 <br /> 6 Trianspotter 1 Company'Niune U.S.EPA 10 Number <br /> AMERICAN VALLEY WASTE OIL, INC CAR000272302 <br /> 7'1 tallsportw 2 Garrlpany Name U.S.EPA ID Numbior <br /> STERICYCLE SPECIALTY WASTE SOLUTIONS, INC MNS0001 10924 <br /> 8.Designated Facility Name and Site Addres"CHEMICAL RECLAMATION SVCS U.S—EPAbNo. be-,TXD046844700 <br /> 405 POWELL STREET <br /> AVALON,TX 76623 <br /> Facility's Phone*.214-627-3224 <br /> 98 9b,U.S.DOT Desonfitlon(including Proper Shipping Name,Hazard Class,ID Number, 10.Containori's 11,Total 12.Unit 11`41,laste Codes <br /> HM and Packing Group(if any)) No, Type Quantity Wt.,Nol <br /> A <br /> RO,LIN1.993,WASTE FLAMMABLELIQLADS, N.O.S.,3,PGII, 1 om 66 G UIJU I Liu 16 33'i <br /> GASOLINE,OIL OUTS i-211-11-4 <br /> 3 <br /> 14 8 !cial Handling Instructions and Additional Infor ation <br /> P9 ' <br /> 0FILE#868367-00 AGED ERG#1218 <br /> EMERGENCY CONTACT:CRAIG <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: :hereby declare that the contents of this consignmew arefuldy and accurately described above by the proper shippirg name,and we classified,packaged, <br /> marked and labeled1placarded,and are in all respects in proper condition for transport a(,f.,crd!ng 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 ConserL <br /> I certify that the waste minimization statement identified m 40 CFR 26127(a)(if I am a large quantity geneiaticr)oir(b)(if I am a small cuantity generator)is true, <br /> Generalor'siOfferor's PrWed[Tylperi Marine Sigwtu 06 Month Day Year <br /> -j 16 International Shipments <br /> I— ri Import to U.S. Exp.rlrom U.S Port q-toyoxtt .......... <br /> Transpon4nr signature(for exports onlyl� Date leavirvj U.S.: <br /> 17 Mate ars <br /> LU TransporlerAcknowledgment of Receipt of M <br /> Ir Tea e limed Name <br /> 0 <br /> CL <br /> salur <br /> —A !U, ljy& <br /> 18 Discrepancy <br /> Discrepancy Indication Space U <br /> Qua",ty Type Residue El Partial RejRejectionFull Resection <br /> Manifest Reference Number: <br /> >- 18b.Altercate Facility(or Generator) <br /> U.S,EPA ID Number <br /> 0 <br /> Facility's Phone: <br /> Uj Ift.Signature of Alternate Facility(or Generator} aianth Day Year <br /> 19.Hazardous Waste Report I'l4anagemen,Method Codes;,,,a.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> UJ <br /> I fl D <br /> 20; Design.Ad Facility Owner or Operator:Cedif cation of receipt Aazarclous materials covered by the manifest e) I as noted in Item <br /> Printeovyl <br /> EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. <br />