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Please print or type. Form Approved, OMB No. 2050-0039 <br /> UNIFORM HAZARDOUS 1 . Generator ID Number 2. Page 1 of 3. Emergency Response Phone 4. Manifest Tracking Number <br /> WASTE MANIFEST CAL000368140 1 800-535-5053 019560754JJK <br /> 5. Generators Name and Melling Address Generator's Site Address (if different than mailing address) <br /> TTL AUTOMOTIVE ENTERPRISES INC DBA OILSTOP 301 W KETTLEMAN LN <br /> 2795A DEL MONTE STREET LODI CA, 95240 <br /> WEST SACRAMENTO CA, 95691 -0000 <br /> Generators Phone: 2 9-368-9779 <br /> 6. Transporter Company ame U.S. EPA ID Number <br /> CLEANTECH ENVIROMENTAL CAL000399638 <br /> 7. Transporter 2 Company Name U.S. EPA ID Number <br /> 8. Designated Facility Name and Site Address U.S. EPA ID Number <br /> AGRITEC INT DBA CLEANTECH ENVIRONMENTAL CAL000330453 <br /> 5820 MARTIN RD <br /> IRWINDALE CA, 91706 <br /> Facilitys Phone: 6264112w7200 <br /> 9a. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11 . Total 12. Unit 13. Waste Codes <br /> HM and Packing Group Cif any)) No. Type Quantity WtNol. <br /> 1 , NON-RCRA HAZARDOUS WASTE SOLID (ABSORBENT/PAPER FILTER MEDIA) <br /> O 1 DM 100 P <br /> Q 352 <br /> LU <br /> 2. NON-RCRA HAZARDOUS WASTE SOLID (OILY SOLID WASTEWSED METAL OIL <br /> FILTERS) 2 DM 400 P <br /> 352 <br /> 3. <br /> 4: <br /> 14. Spedal Handling instructions and Additional Information <br /> Line 1 , USE GLOVES AND GOGGLES. CALLER MUST IDENTIFY CLEANTECH ENVIRONMENTAL AS REGISTRANT: INFOTRAC 800-535-5053; Line 2: USE GLOVES <br /> AND GOGGLES, CALLER MUST IDENTIFY CLEANTECH ENVIRONMENTAL AS REGISTRANT: iNFOTRAC 800-535-5053; <br /> 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, <br /> marked and labeled/placarded, and are in all respects In proper condition for transport according to applicable Intema6onai and national governmental regulations, 0 export shipment and I am the Primary <br /> Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowiedgment of Consent. <br /> I certify that the waste minimization statement Identified in 40 CFR 262.27(a) (d I am a targe quantity, generator) or (b) (if I am a small quantity generator) is true. <br /> Generato er s PrIntedIryped Name Signature Month Day Year <br /> NICK OOELL NICK O$ELL 11 15 2018 <br /> 16, International Shipments <br /> ❑ import to U.S ❑Export from U.S, Port of entry/exit: <br /> Z Trans rter signature for exports only): Date leaving U.S.: <br /> ed W 17. TransporterAcknowledgmentofReceipt ofMaterials <br /> Transporter 1 Printedflyped Name Signature Month Day Year <br /> a JOHN AFLEJE JOHN AFLEJE 11 15 2018 <br /> I z Transporter 2 Pdnted/Typed Name 151griature Month Day ear <br />� F <br /> 18. Discrepancy (—� <br /> lea. Discrepancy Indication Space El Quantity Dype ❑ Residue ❑Partial Rejection [:] Full Rejection <br /> i <br /> Manifest Reference Number. <br /> 18b, Alternate Facility (or Generator) U.S. EPA ID Number <br /> J <br /> V <br /> Un Feclli s Phone: <br /> 180. 8rgnatursofAlternate Facility (or Generator) Month Day Year <br /> a ; <br /> z <br /> 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> 0 1 . 2. 3. 4. <br /> H141 H010 <br /> 20. Designated FadNly Owner or Operator. Certification of receipt of hazardous materiels covered by the manifest except as noted in Item lea <br /> Printed/Typed Name Signature Month Day Year <br /> GRACIE D SOTO GRACIE D SOTO 11 20 2018 <br /> EPA Form 8700.22 (Rev. 1247) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-WI (FEST SYSTEM <br />