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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST t k.11 1 1 1 J J K 5.Generator's Name and Mailing Address Generators Site Address(if different than mailing address) n� Generator's Phone: tib" Q�' 6.Transporter 1 Company Name U.S.EPA ID Number 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number :LEAfSTECH ENVIRONMENTAL 5520 MARTIN RD !R;4rntt�a�•E,nA 0i705 Facility's Phone: 9a, 91b.U.S.DOT 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 Wt.Nol. 1. O 1 I t _.-_._._�.__ w ! Z 2" 4,1+,tti4.t;M f-✓'4.tti;llJLt:��tiJASTE;�C3LtD j 01LY 3CLID vw AiTEi;fSE!C; C tET•P.L OIL FILTERS �- 3. L 4. 14.Special Handling Instructions and Additional Information 9t�b IJSEGLOVES AND GQCC3LE3TANKEf" .fkPER FILTER) _ (MeT'A.!F4l..TF -,'T IDENTIFY GL 15. GENERATOR'S/OFFEROR'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, 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 Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment 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 am a small quantity generator)is true. Generator's/Offeror's PrintedfTyped Name Signature Month Day Year J -16.International Shipments i- ❑Import to U.S. ❑Export from U.S. Port of entry/exit: Z Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year O CL cn zQ Transporter 2 Printed/Typed Name Signature Month Day Year H 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type EJ Residue Partial Rejection Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U ALL- Facility's Phone: w - 1 18c.Signature of Alternate Facility(or Generator) Month Day Year Q Z rnrn 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1. 2. 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. DESIGNATED FACILITY TO GENERATOR