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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Mifest ackin Number <br /> WASTE MANIFEST CAR000285262 J. 408-363.-3578 15 2 0 7818 JJK <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> METAL FINISHING SOLUTIONS - STOCKTON <br /> 1325 ET PINAL DRIVE <br /> STOCILTON, CA 95205 <br /> Generator's Phone: 01 A 84-4--47"Ai <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> ALL CLEAN 1HAS,ARDOUS WASTE REMOVAL INC CAD98249 399 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> TEMARRY RECYCLING INC_ CAR000194217 <br /> 8.Designated Facility Name and Site Address " U.S.EPA ID Number <br /> RECICLADORA TEMARRY DE MEXICO <br /> CARR£TERA_ FEDERAL NO- 2 MEX, SAN PABLO TECATE BC <br /> Facility's Phone: 619-270-9453 1 <br /> 9a. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> HM and Packing Group(if any)) <br /> No. Type Quantity Wt.Nol. <br /> 1.RQ, UN3266, 'HASTE CORROSIVE LIQUID, BASIC, (;,., �J"� D002 121 <br /> p $ INORGANIC, N.O-S_, 8, PG-II (SODIUM TP G <br /> DISILLICATE, SODIUM HYDROXIDE) <br /> z 2. <br /> LU <br /> C7 <br /> 3. <br /> 4. <br /> 14.Special Handling Instructions and Additional Information <br /> 1) R19-26972 CAUSTIC CLEANER (pj x 7 43 _ 1516.5- <br /> PRIMARY <br /> 5S.5-PRIMARY EXPORTER- TEMARRY RECYCLING INC.020526/10E/18, 020539/10E/18, 020514/9E/18 <br /> AC PO# 15106 <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. <br /> Generator's/Offeror's Printed/Typed Name Signature Month Day Year <br /> Int rn tions Shipment§ShipmentQ <br /> 1:1Import to U.S. Export froU.S. Port of entry/exit: <br /> ? Transporter signature(for exports only): Zee Date leaving U.S.: Z <br /> W 17.Transporter Acknowledgment of Receipt of Materials <br /> Transport r 1 Printed/Type ame Signature Month Day Year <br /> a <br /> z Transphirteir 2 4tedfTyped Name-----j Signature Month Day Year <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space <br /> ❑ Quantity ❑Type El Residue El Partial Rejection El Full Rejection <br /> Manifest Reference Number: <br /> 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> J <br /> U <br /> LL Facility's Phone:. <br /> w 18c.Signature of Alternate Facility(or Generator) Month Day Year <br /> a <br /> z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> Cn <br /> 0 1. 12, 3. 4,% <br /> 20.Desig;nged Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a <br /> Printed yped Name Signature Month Day Year <br /> EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR <br /> L <br />