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<br /> Please print or type. Form Approved.OMB No.2050-0039
<br /> UNIFORM HAZARDOUS 1 1.Generator ID Number 2 Page I of 3,--merg Response Phone Manifest Tracking Number
<br /> WASTE MANIFEST CAL000401815 I 8775742669 012496362 F L E
<br /> 5,Generator's Name and Mailing Address Generator's Site Add"fess(!f dil'ierent than Mailing ad:,IreSSi
<br /> Marshalls #MO122 flarshalls#M0122
<br /> 2099527870 2203 Grand Canal 2203 Grand Canal
<br /> Generators Phcr%,: Stockton, CA 95207 Stockton, CA 95207
<br /> 5 Transporter i Company Name US EPA 10Nimper
<br /> StL
<br /> .ricYcle Specialty Waste Solutions Inc IMNS@00110924
<br /> I Transporter 2 Company Name U S EPA 10 Number
<br /> Worldwide Recovery SystemsICAR000175422
<br /> 8 Gosgriated Facility Name and Site Address Y U M a Y e 9, ILL L, U,,S EPA1:)Nur-,t;er
<br /> 2730 E. 13th Street
<br /> Yuma, AZ 85305
<br /> Facl-y's phorip.9286426936JAZR@04 h515924
<br /> 96J,S DOT Des-—ptirin ii-c;.u6nq Rm.,)er 5ti oping Name,Hazar"I Uc)sb,. Vnl�fli,
<br /> Hf? and Pac�,rg Group;d any) - ,y
<br /> Nr, _77ype Quant�*,y At iv
<br /> Non HL;HR hazardous waste, soiia (GonsumeF I P 15,31
<br /> O Products),
<br /> Z 2.
<br /> LU
<br /> 3.
<br /> 1, Special Hamllkiq lirs:ructions and Additional information 1. 10233'�HCA State Repulatsid 13o12d5)
<br /> 15- GENERATOR'SIOFFEROR'S CERTIFICATION: l hereby OaClariy thilt air ants of•^s corsinlrre,,t are fully am,acctrateiiy described above by the proper shipping name,am a44_SV_Wrpackaged,
<br /> marked and laWediplacrardea,and are in all respects in proper condition for transport accordirg t,npUWe kriterailionsilarid national governmental regulations if export shipment and 1 am the Primary
<br /> Exporter,I certify that the contents of this cowgrimeM conform to the!err -f!nFattaned 4-PAA(,,-1�we:Irtrimen!nfCcrisent
<br /> I certify Inat the waste minimization statement identified in 40 CFR 262 271,w,,f I am a taiga it.anNi gpr,,,iato,or,u)0a"Ia tirra i ouun:1ty gefieraL,'i is true
<br /> Generatons/Olfferor's Printert(Typed Name 51,nal"�Xt behalf of Mo�fl,, Day `!'ear
<br /> EL� 03 �FA
<br /> _j 16 International Shipments
<br /> I— F1 Import to U.S. Q Export fp,,n u S. P';rt ot4ntry,exIt ----—------
<br /> K Transporter signature(for exports only): Gate leaving U.S_
<br /> W. 17.Transporter Acknowledgment of Receipt of Ma"Iri
<br /> Uj
<br /> F- Transporter I Prime&
<br /> Typed Name //a,nature Vr�,rth Dar "Pa,
<br /> 10,3 1 28 k019
<br /> z Tra T, d_/TyDed Name 14-1,n:h Dav Year
<br /> (CG\c/
<br /> 18.D screp
<br /> 18a 7D
<br /> Pancy indication Snare
<br /> Res.iiie, Partial Reie=n
<br /> Manifest Reference Number.
<br /> l8b.Alternate Facility(or Generator)
<br /> U&EPA LNumber
<br /> Failys
<br /> ZEItalL�n!
<br /> F g7n ,,;.tA!,,,mateFaci!ity(or Gens ral,�,r)
<br /> 7
<br /> Fly
<br /> 19.Hazardous waste Report Management Method Codes for nazjrr�Gus Ai,nite iejtnler:,J,sposal and recytim,sysjfin$}
<br /> LU 1
<br /> 2.
<br /> manifest the exc--pi as a,#eci Q Ism 18a
<br /> Pr;t t ed Na. Signature Month Day Y r
<br /> EPA Form 8700-2 (Rev.12-17) Previous editions are obsolete I
<br /> ST SYSTEM
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