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Niff"wil ingli"lm*plgmx 11W lion No <br /> Please pdrd or type. O 0 a e s ? 4 0 6 $ K $ <br /> Form proved.OMB No.2050.0039 <br /> UNIFORM HAZARDOUS 1•Generator ID Number 2 1 of 3. 4.Mentfaet TrsckingNumbv <br /> WASTE MANIFEST 006687408 SK S <br /> 5.Generates Name and Mash Address Generators Site Address(N different then maii address) <br /> ADM — Sol�en Gate ADESA — Golden Gate <br /> i8581 West Stanford Rd Attn Samuel Mchenry 16581 Stanford Rd <br /> TIDY CA 95377 Attn Lester Sabo <br /> Generators prone: 509-814-5374 TRACY CA 953'7-3708 <br /> TtWVfqtEdW SYSTEMS INC U.S EPA ID Number TXROMBIM <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> 8.Designated FadlNy Name and Site Address QTY—KL EEN OF CALIFORNIA <br /> U.S.EPA ID Number <br /> 6668 SIMIITH AVE, <br /> 510-795-4488 NEWARK � CA 94560 <br /> Fadkr{s Phase: CAD988887418 <br /> 9a, 9b.U.S.DoT Descrynon QWudhg Proper Shippkv Name,Hazard Class.ID Number, 10.Contelners 11.Taal 12.Unk 13.wase Codes <br /> HM erd 9 GmUP(N anY)) No. Type Qua" wtnfa. <br /> 1• NON RCRA HATARDOW WASTE,LIQUID UQ i TT �S G 133 <br /> ETHYLENE GLYmL SOLUTION iLE5S THAN 5") <br /> z 2. <br /> LU <br /> C9 <br /> 3. <br /> 4.- <br /> 14.Special Handling lnstrudronsand Addhonallnformatiut TSD:EV6 AD28198 CSGt: <br /> 24H EpIERSENCY# 66-1768—CH/SK/TFI—Contract retained by generator confers a envy authors y <br /> an initial transporter to a or substitute additional tran rters r' <br /> .1 behalf, <br /> 15. C-ENERA7W&WFMWS CERTIFCATION:l na e4 dedsre tris dmoontets of tt&calstgrrnent are fly and acmireley desurbed abm by the proper shipptrg name.are are aogild,pedraged, <br /> mar+tea and labeledrp�carded,and are�ai respects h proper oondleon for transport acoord'ag to applk�ble in>ema6onal and rlaticnel gavemmergal regrda8ons.N export> d ark i am aIa Primary <br /> E,Pater,I w*that the w1dems of mss corormem obntam to the temis of the shoaled EPAAdano0monent of Consent. <br /> I ow*Mat the waste rrinknimion statement identified in 40 CFR 282.27(a)(N I am a large quantih+generator)or(b)(NI am a smai quantity generator)is true. <br /> J 46.klmrnadona!SMpn>arlm <br /> ❑knportto U.S. ❑Exporlfram U.S. Port o(en"Jo k <br /> El Transportsr signaeae(for exports ony): :late Ieavklg U.S.: <br /> 17.Transputer of Receipt of Materials <br /> leTM��Pypad q'#1 - <br /> Rd I - Mardh Day Year <br /> 0 l I <br /> TrxispDr*APivadllyped Name Signature Month Day Yeg <br /> 18 Discm"ncy <br /> 18a.Disaepacy Infcahon Space ❑ Quantity ❑Type ❑Residue ❑Pattal Rendon ❑Fuk Rejection <br /> Manifest Reference Number. <br /> 180.Alternate Facft(or Generator) U.S.EPA ID Number <br /> J_ <br /> V <br /> F,,iWs phone: <br /> W 18c.SVeture otAltemete Faddy(or Generator) Month Day Year <br /> 19.Hazardous Waste Report Management Method Codes(i.e..codes for hazardous waste trwtment,dlspoaal,and recydkg systema) <br /> p 1• ' 2. 3. 4. <br /> �_\ <br /> �A \ I <br /> 20.Designated Fadity Owner or Operamr:Certification of receipt of hazardous materials covered by the manifest except as ncoed in Item 18a <br /> odwnrryped Name natu mom Day Year <br /> g— <br /> Vffn e Jffgje 012-17) Previous ins are obsolete. DEOffNATED FACILITY TO EPA's 9-MANIFEST SYSTEM <br />