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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS jI,GpneraIor1DNvmber2.Page-1 or 3,Ems rgency Rasponse Phone 4.Manifest tracking Number <br /> WASTE MANIFEST I C A L 0 0 0 2 9 e 7 0 0 1 11-800-424-9300 013481281 J J K <br /> 5.Generator's Name and MaigngAddress Generators Sift Address(i1d81eranl than M24q address) <br /> Cooks Collision of Tracy Cooks Colfisicn of Tracy <br /> 1104 Main St 2830 Auto Plaza Dr#110 <br /> Redwood City CA 98304 Tracy CA 05304 <br /> Generakes Phone: q <br /> 0.Transporter 1 Company me U.S.EPA ID Number <br /> Environmental Logistics, Inc. IC A R 0 0 0 2 1 7 6 1 3 <br /> 7.TrensWer2Company Name U.S.EPA O Number <br /> 8.Designated Fadhty Name and Site Address U.S.EPA1D Number <br /> Filter Recycling Services,Inc. <br /> 180 W.Write Avenue <br /> BlooMngton CA 92318 <br /> FaciAlYs Phone: Q09 4 2 1-20 12 C A D Q g <br /> ga. 9b.US.DOT Description(Indo ing Proper Strppirg Name,Hazard Class,ID Ncnnber, 10.Containers111Tote) 12.UnA <br /> K%A I and Pigg Group(1-0) No. Typa Ouaritty 191AOol. 13.Waste Codes <br /> 111lon-RCRA Hazardous 1Maste Solid(BondD must) 352 <br /> 0110 P <br /> Non-RCRA Hazardous Mste Solid(Er1•rpty Paint Cans) 352 <br /> om p ..... <br /> i <br /> 4. <br /> t4,Spatial Hinting IrssW tons endAddi6onal In(orma6on 1)(S)Bondo 6Ust- 18011807 2)(S)Ernpty Paint Ca - 15022010 M#4237&N <br /> 15. 0 ENERATOR'SICFFERORIS CERTIFICATION.,I hereby declare that the contents of IhLs consIgwent are idly and scmately descrbed above by the proper shipp4 name.ard are dassilled,padned, <br /> marked end fabeied/placarded,and are InArespectsInpropercoo tonfortransportaccordingtoapplicablehtemaWnalandnationalgovemmentalregulatons.IfexportshlpmentendIamthePrimary <br /> Exporter,I cenity that the conlerds of this coWgrmtent conform to the terms of the attached EPAAckn Adgrnent of Consent <br /> I cerJfy ftt tha watle minimlzatlon stalemenlldentmed in 40 CFR 262.27(x)(d i sm a terga quer*gerseralor)or(b)(4l am a small quanblygeneralor)Is We. <br /> Generaloesl0 sQ6nted/rypedName r"' SignehKe A4on1h Day Year <br /> 1201 <br /> � 18.Inlematron Sh�pmenlS <br /> ❑Import to U.S. ❑Export from U.S. Port cf entryftxit <br /> Transporter signature t(orexpo((smly),___.__. Date leaving U.S.: <br /> o= 17.TransporterAckrwMedgmenl of Receipt f Materials <br /> oTrangpatar 1 PdMetVTypad Name ftnatu Moruh Day Year <br /> (/�1 3 2,a <br /> Q Transporter 2 Printed yped Nam Signature Month Day Year <br /> 18.Disuepancy <br /> 18a.Oiscrepency Indication Space El Ouanbly ❑Type 0 Residua ❑Pargal mectbn ❑Ful Rejeckn <br /> Walks!Reference Number. <br /> 18b.A woale FacTjV(or Generalor) U.S.EPA ID Humber <br /> U <br /> W Fadityrs Phone: <br /> 1Sc.Signature of Alternate Facility(or 8enerator) Month Day Year <br /> 19.Hazardous Was to Report Management Method Codes(i.e.,codes for hazardous waste trealmenl,disposal,and re4*Tnng systems) <br /> 1. 2. 3. 4. <br /> iff <br /> natedFa .Vl CNnerorOperator.CertiBca6onofreceiptofhazardousmaterWscoveredtrythemanlWtexceptasnotedinItem18a <br /> ypedName Signature tenth Day Year <br /> EPA Form 3700-22(Rev.3.05) Previous editions are obsolete. <br />