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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 Z Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST I of 5.Generator's Name and Mailing Address U 'te Address(if different than mailing address) Generator's Phone: �- 6,Transporter 1 Company Name CLEANTECH ENVIROMENTAL INC. U.S.EPA ID Number CAL000368136 7,Transporter 2 Company Name U.S.EPA ID Number 8,Designated Facility Name and Site Address CLEANTECHENVIROMENTAL U.S.EPA ID Number 5820 MARTIN RD CAL0003 IRlh INDALE,CA 91705 USA Facility's Phone: 626-812-7200 ga. 9b.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.Nol. 1.,.._ s o -- -- � I 2. cUJ a METAL OIL FILTERS) � j i I 3, 4. k 14.Special Handling Instructions and Additional Information 02)PROFILE#Oji�� 1: ----- USE GLOVES AND GOGGLES TANKER# `- .: ' (METAL FILTERS) , CALLER MUST IDENTIFY CLEANTECH ENVIROMENTAL AS REGISTRANT.INFOTRAC:800-535-5053 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described ab"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 go rrniehtal gagulaiions.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 GFR 26127(a)(if I am a large quantity generator)or(b)(if I am a small agji(gen tor)is true. Generator' erors PrintedfTyped Name Signature 1.4 Month Day Year o .J 16.International Shipments p— ❑Import to U.S. ❑Export from U.S. Port of entry/exit: Transporter signature(for exports only): Date Ie ing U.S,: 17,Transporter Acknowledgment of Receipt of Materials 12 Transporter 1 Printecirryped Namet Signature Month Day ye r 0 a . va Q Transporter 2 Pdnte/Typed Name Signature Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ QuantityType❑ yp ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J 4, W Facility's Phone: 18c.Signature of Alternate Facility(or Generator) Month Day Year Z 0 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) ® t 2. y 3. 4. 20.Designated Facility Owner or Operator:Cortificatipmof receipt of hazardous ma rials covered by the manifest except as noted in Item 18a Printedrryped Name Signature Mo h ar EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. DESIGNATED F C ITS'TO DESTINATION STATE(IF REQUIRED