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.�.. N _M ¢» II I II I III I II I I ILII II IIIIII i l 11 l I I III >�., y C 330976-18 001965059PSC 3303790-001 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 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CAL000310240 1 (877)577-2669 001965059 PSC 5 Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) MCLANE FOOD SERVICE MCLANE FOOD SERVICE 800 PESCADERO 800 PESCADERO AVENUE TRACY,CA 95304(209)221-7541 TRACY,CA 95304 2092217541 Generator's Phone: 6.Transporter 1 Company Name U S.EPA ID Number STERICYCLE SPECIALTY WASTE SOLUTIONS INC MNS000110924 7 Transporter 2 Company Name US EPA ID Number 8.Designated Facility Name and Site Address U.S EPA ID Number YUMA YES,LLC AZR000515924 2730 E.13th Street, Yuma AZ 85365 Facility's Phone. 9a 91b.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.!Vol. 1.. NON- / ARDOU$WASTE I I ) O "x A_- Q a Z 2. NON-RCRA HAZARDOUS WASTE,LIQUID(DETERGENT,BRAKE FLUID) Lu 133 2a R6 296 P s.r4ow p e Rik t%A-7 AV-LIN J5 LJ A STS 1.1 PU 0 4. �14 PC.IRA tkl't'2Rt US WAST 0$1v1"0 14.Special Handling Instructions and Additional Information (1 727321:02:MERGQ 727321-02-DRUMS WITH RESIDUE OF OIL IN THEM<S�%„OH (2)MPNONHAZ-05-ERGO PRO#MPNONHAZ-05-NON HAZARDOUS MATERIAL 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 labeled/placarded,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 EPA Acknowledgment of Consent. I certify that the waste minimization statement 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. enerator'sl fferor's Printed/Typed Name Signature Month Llay Year 9 10 1 18 J 16.International Shipments Export from U.S. Port of entry/exit /exit: Z 1:1 Import to U.S. ❑ p ry --- ----- --- - - Trans orter signature for exports only): Date leaving U,S. LW17.Transporter Acknowledgment of Receipt of Materials II Transporter i Printed/Typed Name Signature Month Day Year c Andy Winkler ( ;..;f I 9 I 10 18 ZZ Transporter 2 Printed/Typed Name Signature Month Day Year H 18.Discrepancy 18a,Discrepancy Indication Space El Quantity El Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 181b.Alternate Facility(or Generator) U.S.EPA ID Number J_ V Q LL Facility's Phone: Lu 18c.Signature of Alternate Facility(or Generator) Month Day Year Q Z 0 N 19.Hazardous Waste Report Management Method Codes(i e.,codes for hazardous waste treatment,disposal,and recycling systems) LU 1 2. 3. 4 H7.3- 20,Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed Typed Name Signature Month Day Year EPA Form 8700-22(Rev.3-05)Previous editions are obsolete. , DESIGNATED L • •