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;I I <br /> a <br /> Prase print,of stype. For Approved_ONIB Na.2050-0039 <br /> UNIFORM HAZARDOUS1 Genera yr iC N,.rube. € 2 �1 ? Erer ,y Respmse Phony #.Manifest Trackin Nt m r <br /> WASTE MANIFEST CL000018£ 9 i 87-)!5772669 <br /> 5.Gereratoes Na^re and Makro Address Canerata Sole Address ted fereM d an mai;ng address! <br /> ` <br /> Kmart #3174 Kmart#3174 <br /> 099488205 2180 C Mar^ipo a Rd 2180 E Mariposa Rd <br /> Generators Phone: St eckt fll'a, CR 95205 Stockton CA 95205 <br /> 6.Transporlee 1 Gumaarty Mame U.S.EFIA IV Number <br /> Steri.cycle S ecialt a5te SOlutiDns Inc LMNS000110924 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> Worldwide Recovery .tea ''tems CAROOL4175422 <br /> tt.GesgrrtadFaclityNamearilSite Address Yuma Yes LLC U.S.EPA,UNumber <br /> 2730 E. 13th Street <br /> pf' �y^� Yuma, AZ 85365 � *p b�yfA (� <br /> Fa ilitysProw 92286428'938 1 AZR000515924 <br /> Sa. 9b,U.S.DOT Description(including Proper Sa pw..g Name, <br /> . and Claw 10 Number 10.Conto ners 11.Total 12-Urfti Waste Codes <br /> Ha)r ar=d Packi Group(if anfyT Po. Tyc1O:antiy hre`Vei, <br /> on HURA hazarElous waste, sr id Mansumer 2 17F 00298 A 56 <br /> 0 Products), <br /> �t <br /> z 2. o azar taus was e, liquid (Consumer 2 D F —0-K-—89 A 56 <br /> 0 Products), <br /> 3. <br /> 14,Special handling Instructions and Additional Information 1. 029ffGTCP779'f—ate Reguid ed ba 'Vis) L State e g g aG <br /> Liquids) <br /> ft 69-3 <br /> w <br /> tS GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby dela 0 that the contents of this consignment are fully ar ¢accurate€y described above by the prcpei,shipping name,aril are classified,packaged, <br /> marked and IaWed pia»a ded,and are in all respects in proper itlon for transpod accorling to applicable anter Exporter, <br /> c sal and na knot go:srnr lent al re$�iatlons.If expo t sh=pr ert a p I am trw Prarnary <br /> Exporter,I co0y that the.omens of this con"rirnen conform t the terms of 11,a attached EPAAcknow€edgment Consent <br /> I 00"that the waste Minimization staternent identified in 40 CF R 262.27{a)(it i ant a large quantity generator)or i om a small qua'Pty generator} true. <br /> Gr r orvogeror's P€trttadffyped NamaSgnature Month Day year <br /> /71 <br /> 16International S ipments (�"`'```gg <br /> t Q f rpor to U.S, t l Export fron U.S. P a t of enby ex t: <br /> Transiorter signatuni(lor exports onty): Date teavml;;U.$.: <br /> tri 17 Trsns{bderr Ackncw`ertgme�t a4 Ret�ipf of C�aterlals <br /> Transporter 1 PrintedTTyped N Signature Month [lay Year <br /> €'- Kristopher- Almanza �.; 3, .u1-P <br /> Z Tr sparter2 P'ntedRypec N e Signa`r Month Day Year <br /> g1L <br /> 3 pa- <br /> 18.Dsnrepancy <br /> fa Mwrepancy indication Spare ❑Quantityeject` L I Full Rejection <br /> Type Reid e Partial€ ' mn <br /> Ma est Reference Number: <br /> tSb.Al ernake.a l ty(rte et2knri U.S_EPA'D Number <br /> Yr Facky's Phone, <br /> 1E..Signature ate ternate Facility(or Ganeratcc) Month Day Year <br /> z <br /> 19 Nazardcus VPste Report Management Method Godes(i.e-code far hazardous waste treatment,dspcsaf,and req Orig sys e€us) <br /> €t7 1. 2, d. d, <br /> 0 <br /> 29,Designated a-i:i -Ck'.or Operator.Certification of wei rt of izardous materials covered by the manifest woo s noted any i em 18a <br /> Pr nkedrTyped Nan e! I Signature Month Day Year <br /> C I <br /> EPA Forrn 870D-22(Rey.12-17) Previous ed: s are obsolete. �t O)ESIGNATE15FACILITY([_ITY TO EPA's e-MANIFEST SYSTEM <br />