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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Fonn Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Wormiest Tracking Number WASTE MANIFEST L Q 1 (800)424-9300 1 018531282 JJ K 5.Generator's Name and Mailing Address µE V R 0 L-GT - a A No o 1 Generator's Site Address(d different than mailing address) 60"d M 1 634 TZA Y 3400 A ATO P 47,A WAY Gene to s hone: LOL 5�0 6.Transporter 1 Company Name U.S.EPA ID Number WORLD OIL ENVIRONMENTAL SERVICES ICAD028277036 7.Transporter 2 Company Name U.S.EPA ID Number WORt-b z t 2, 0V m or-7s4aa 8.Designated Facility Name and Site Address U.S.EPA ID Number YES MANAGEMENT, INC. 6500 US HIGHWAY 95 YUMA CA 85365 Faciii s Plane: (928)344-9828 JAZR000521146 ga. 9b.U.S.DDT Description(Including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Packing Group(If any)) No. Type Quantity WUVoI. c 1NON-RCRA HAZARDOUS WASTE,SOLID(OILY SOLID. PAPER FILTERS) DIA P z 2. W 3. 4. 14.Special Handling Inshucttons and Additional Information EMERGENCY CONTACT:CHEMTREC 1-800.424-9300 WOES TERMINAL *PROFILE#981:OS-PF CERES *ADDITIONAL-=& /� CODES:981:.NONE*APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT'4 ad )a, a X �5 �ZP .9 . 15. GENERATOR'SlOFFEROWS 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, marked and labeled/placarded,and are in sit respects in proper condition for transport according to applicable International and national governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgmenl of Consent 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 quantity genera e. Generat6r s10tTeror s P' ame Stgnalure Month Day Year -1 116.International Shipments I-- ❑Import to U.S. ❑Export from Port of enbyfaxit Transporter signature(for exports only): ate leaving U.S.: 17.TranspoderAdwMedgment of Receipt of Materials aTransporter 1 Pdnted(fyped NameSignature Month Day Year a Ina V 0'7 W T r am Signa on Day ear r 18.Discrepancy, Zr- i8a.Diss�ai1 Indication Space ❑ Quantity ❑Type Residue ❑Partial Rejection ❑Full Re)ectton Manliest Reference Number. 18b.Alternate Facility(a Generator) U.S.EPA ID Number J_ V LLC- Facility's Phone: LU 18c.Signature of Alternate Facility(or Generator) Month Day Year Q z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) G 1. 2. 3. 4. b 20.Designated Facility Owner or rotor.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printedlryped Name Stgnatureth Day Year G l EPA Form 8700-22(Rev.3-05) revious editions are obsolet . DESIGNATFACIL DESTINATION STATE(IF REQUIRED)