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D^TSC - 0.4.57 5.- I. 547 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 CAL 0 0 0 4 0 016 7 1 (800)424-9300 017791463 JJ K- 5.Generators Name and Mailing Address Generators Site Address('d different than mailing address) SPEEDEE OIL CHANGE&TUNE UP-GRANTLINE RD 245 W.-LOUISE AVE MANTECA CA 95336 711 W. GRANTLINE RD Generators Phone: 209 836-1557 TRACY CA 95376 6.Transporter 1 Company Name U.S.EPA ID Number ASBURY ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number US ECOLOGY VERNON INC 5375 SOUTH BOYLE AVENUE LOS ANGELES CA 90058 CAD097030993 Facility's Phone: (323)277-1500 ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(if any)) No. Type Quantity Wt.Nol. 13.Waste Codes c 1'NON-RCRA HAZARDOUS WASTE,SOLID(OILY SOLID, PAPER FILTERS) 352 DM P z 2. W 3 t 4. 14.Special Handling Instructions and Additional Information .fZ 303 2- EMERGENCY EMERGENCY CONTACT:CHEMTREC 1-800-424-9300 WOES TERMINAL:CERES CS *PROFILE#961:P209724.0ILY SOLID, PAPER FILTERS *P500-00056368*APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT 4fek?'ArD," Zkc 5- 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, 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 EPAAcknowledgment of Consent. I certify that the waste minim' on stat ant identified in 40 CFR 262.27(a)(if I am a large quantity generator am a small quantity generato is to rots Printed/fy ame Month Day 'Year �9 [00 .j 16.Intem 'nal Shipments r~ Import to U.S. ❑Export from U.S. Port of entry/exit Transporter signature(for exports only): , Date leaving U.S.: W 17.TransporterAdmowledgment of Receipt of Materials Trar 1 Pdnted/r ped ame Signature Month Day Year rTA L/ d d 9 11� aTransporter 2 PrintedriVI Name Signature Month Day Year OC . r` 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity [:]Type. ❑Residue ❑Partial Re action J ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J V . LL Facilitys Phone: W 18c.Signature of Alternate Facility(or Generator) - Month Day Year a z H19.Hazardous Waste Report Manageme2ethod Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 1. , 2. 3. 4. y, 20.Designated Facility Owner or Operaf6FQrtification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Pdntedrryped Name Icy Signature Month Day Year EPA Form 8700-22(Rev.3-05).Previous ditions are obsolete. DESIGNATED FACILITY TOST ATION STATE(IF REQUIRED) 12871 .0596