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L <br /> Please print or typ& Form AWuved.OMB No.2050*On <br /> UNIFORM HAZARDOUS 1.Generabr ID Number 2.Page 1 of. 3.Emergency Respot8e Phone 4.fiNnlfast u <br /> mim <br /> WASTE MANIFEST 14 1 209-482-4571022516465 JJ K <br /> s,Generator's Name and Ma"Address Generator's SileAddress crf diffareM than malting aadrees) <br /> SMART TECH DIESEL REPAIR <br /> 795 E ROTH RD <br /> 1=RI<NCH CMAP,CA 95231 <br /> t.�erreratcr's R=209-482-4371 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> AMERICAN VALLEY 1AfASTE OIL, INC. U.S, <br /> " <br /> 7,Transporter 2 Company Name U.S.EPA Id Number <br /> WORLMDE RECOVERY SYSTEMS INC CAR000175422 <br /> B.Designated Facpgr Name ane YUAMA YES 2 WASTE TRANSFER FACI LfTY U.S.EPA ID Number <br /> AZR00052114a <br /> 85500 US HIGI-WAY 95 <br /> YlA1M,AZ 83366 <br /> Fadtys Ph.P28-344.6H28 <br /> g& 9b,U.S.DOT DequVoon(MrdW"Proper Shipping Name,Hazard Class,ID Nanber, 10.Conwners A lotat 12.Unit 13.Waste Codes <br /> HM and P"N Group(If any)) No. Type fity w Nd. <br /> 1. FIeL)fJ-RCRA HA7Ai2M115 WA44S E 5O IIS Cafi."EL,ABSORBENT,OIL 1 DM 230 P 352 <br /> O <br /> 3. <br /> 4. <br /> 14.Spedal Handing InstrtrOons arldAdMOnal I <br /> PIROFILEN 2-llDf1 GRAVEL,OIL ERG#171 <br /> EMERGENCY CONTACT: AMAN <br /> 15, OFNERATOWS OFFEROR'S CERTIFICATION: I hereby declare that the cordarrts d this mra0rrrnerd are kh and ecarm*described above by the proper 3Nppkg name,and are classified,packaged, <br /> marred and labsle&*carded,and are In al reaped in p vw oonatlem for ft*W aeoadtrp to appfxabla inw-tlo W and national governmental raoauona.ff export s*wt and I am the Pdnnay <br /> Exporter,t hm the carrterrts of this consionva cadonn to to terns of to attached EPAAdmawledgment of Cmsenk <br /> I tartly that the waste minkizabon aNament ldwMW In 44 CFR 26227(x)(9I on a large quanfity generator)or#)IRI am a Wo qr y generates)Is trw-- <br /> lr <br /> Shlpmem� Li Import to U.S. ❑Export s.(,,,17P(;.f errbyb t <br /> ? Transporter sVmbrre(for exports any): Date laeWrg U.S.: <br /> W 17.Tweep t Admowtedgmant of Receipt of Materials <br /> lu <br /> Transparfer 1 Prq>fedlTyped ffarrls Slgnaheej Y <br /> O17 1 <br /> IL <br /> T:j I I Month 2Z"D]ay� Year <br /> 74 <br /> UaA <br /> t 8.Discrepancy <br /> 1 Be.Discrepancy kxdkatlon Space ❑ G1 w ty ❑Type ❑Realdue ❑Perltcl t7eB**c. ❑Full R.I.*. <br /> Manifest Reference Number. <br /> � } U.S.EPA ID Number <br /> >wrwrle (a Generator) Mom Day <br /> #IAL Afisaepanrerlt hle6rod Codms(Le.,codas is Ilsrzandous weals treahrrerr6 diepoeal,and re+,yding systema} <br /> ti 2. 3. 4. <br /> �s <br /> OrarraOparstsr Crioalur atreualyt lNlplAonFArleAaltc9lllld tyro manffest except as mlad M Nam 185 <br /> Swan Moro Day Yaw <br /> :> :: : 01.12-17)PUeelats R EP.etssm hinUp. DESIGNATED FACILITY TO EPA's 9-MANIFEST SYSTEM <br />