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016774135JJK <br /> Please print or type.(Farm designed for use on elite(12-pltlt)lypewrfter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1. G Ar�DU 0 U 3 71 7 1 S M 2.Pagl1 3.8np81ro�c i 14.Manifest Tracking Number <br /> WASTE MANIFEST 016774135 JJ K <br /> 5 cenerElr �CAR COMPANY Generator's Site Address(if different than mailing address) <br /> 3190 AUTO CENTER CIRCLE <br /> STOCKTON CA 95212 <br /> 916928-4460 <br /> sPoLS$f1RT <br /> Generator's PnorC,a�1pa <br /> 6-Tranpn NMEN7AL SERVICES U.S.ElilIQ"V 8 2 7 7 0 3 6 <br /> 7.Trans"r 2 Campany Name U.S.EPA ID Number <br /> &Dosrpnalad radld Name and Silekd U.S.EPA ID Number <br /> 13S ECO�f}9Y VERNON�IC <br /> 5375 SOUTH BOYLE AVENUE <br /> LOS ANGELES CA 90058 CAD 0 9 7 0 3 0 9 9 3 <br /> FadlitysPhone; 323)277-3.500 <br /> ga. 9b-U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 1p,Containers 11.Total 12 Una 13,Waste Codes <br /> HM and Packing Group(if any)) No. Type Quantity &Nbl. <br /> 1. NON-RCRA HAZARDOUS WASE,SOLID(BRAKE PADS) 352 <br /> DM PUP — <br /> z �. <br /> e-M <br /> 3. 3 <br /> i <br /> I <br /> 14,Spedal Handing InsbuCUons and Additional Intonnation <br /> EMERGENCY CONTACT:CHEMTREC 1-800-424-9300 NAERGO 982;171"PROFILE#981:572628 BRAKE PADS,9132: <br /> AP197504 OILY SOLIDS*P500400043439"APPROPRIATE PERSONAL PnmffMENT I <br /> �! 3/0� <br /> 15- CNERAT0FV=FFER0R'S CERTIFICATION.I hmeby declare that Me cWentsoFthfs ox1°..ignmentare Via end wx=taly das mbW above by the proper sntppog name.a:rd am classified.pac(aged, <br /> marked and IadaleNptacarded,arw are In ad tespacls In pwpercondibun fnr transpoR armminp b oppl mUo kris rwt atsaland natlgnpt ga+re rntanrat regulat)ans.tf c4ort shipment and t am ft Primary <br /> E4x der.I OAthat ft tlontanm of thiscar sgnmem ourdenn b Ste tarns aftnA Attached FPAAC0owk+dgmen1 m consent. <br /> i oerflN dal the waste minimization aratnment Idardfied in 40 CFR 2QU?la)0 t am a tarps quantty gahemv)Or(b){n nr a smaA qmr t7r generator)6 true. <br /> or s PdntedlT ane 5 m Mrrnth Wv Year <br /> bg Z 7 r? <br /> _.r 16.InbMbonal 1pments <br /> ❑Import to U.S. ❑6grod from U.S. Pad of entylexit:_ <br /> TmnsporW*nature(r«exports only)- Date leaving U.S.; <br /> w 17.Tr9rgxra kA ovdedlpwtdReosiplofMaterials <br /> T nor i P ypedSigrraWre hSofrtir Dar Year <br /> co 9 Z <br /> Q Transponer2Pnnt S&tu Month pay Year <br /> t- <br /> 18.Discrepancy <br /> 180,Discrepancy Indication Space <br /> Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> 6tanifest RaFcronm Number. <br /> 1Sb-AlfernWoFacility(« en <br /> Gerator) U.$ EPA ID Number <br /> J <br /> U <br /> Fadi' s Phone: <br /> 1(fc Skartalure el A!Mnafe FaaAy(cx Gow.ratrx) IAwttlr nay Y <br /> 4 <br /> Z <br /> 19.H=fdeus Waste Report Management MaW Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> UA <br /> O 1 M 1 2- 1 4, <br /> k <br /> d FOCI ty Owner a tar Certlix afian of race plot hezartloua materials rxmered by the man'dasteafxpl as haled in Item 18a <br /> Name. Signature nor Day Year <br /> CPA Form 87G0.22(Rev. 45) Previous editions are obsdete. DESIGNATED ACILITY TO DESTINATION STATE REQUIRED) <br />