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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 CAL 0 0 0 4 0 016 7 1 (800)424-9300 018531226 JJ K 5.Generator's Name and Mailing Address Generator's Site Address(it different than mailing address) SPEEDEE OIL CHANGE&TUNE UP-GRANTLINE RD 245 W. LOUISE AVE MANTECA CA 95336 711 W. GRANTLINE RD Generator's Phone: 209 836-1557 TRACY CA 95376 6.Transporter 1 Company Name U.S.EPA ID Number WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 7.Transporter 2 Company Name U.S.EPA ID Number WORLDWIDE RECOVERY SYSTEM INC. CAR 0 0 01 7 5 4 2 2 8.Designated Facility Name and Site Address U.S.EPA ID Number YES MANAGEMENT, INC. 6500 US HIGHWAY 95 YUMA AZ 85365 AZR000521146 FacIlity's Phone: (928)344-9828 ga 9b.U.S.DOT Description(induding 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 WL/VoI. NON-RCRA HAZARDOUS WASTE SOLIDS(PAPER FILTERS) 352 0 1 / DM lr?� P z 2. LU 3. 4. 14.Special Handling Instructions and Additional Information � S386a6 EMERGENCY CONTACT:CHEMTREC 1-800-424-9300 WOES TERMINAL: CERES CS *PROFILE#9131:1626 3NRSSPE099 PAPER FILTERS * *APPROPRIATE PPE EQUIPMENT / / 5� 15. GEN ERATOR'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 labeledlplacarded,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 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. Generators/Offerors Pdnted/Typed Name Signature Month Day Year 16.Intern lfonal Shipments z I ❑Import to U.S. ❑Export from U.S. Port df entry/exit: Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials ;j Trans 1 Printed/Typed Name Signature Month Day Year 0 IL 1)44 Z Transporter 2 PentedfTyped Name Signature Month Day Year AtJ�L 1 � r� ---/ ZW l� 18.Discrepancy 18a.Discrepancy Indication Space ❑ QuantityType ❑ i ❑Full Rejection ❑ yp El Partial Reaction Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number U LL Facility's Phone: W 18c.Signature of Alternate Facility(or Generator) Month Day Year Q 05 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) C 1. 2. 3. 4. 20.Designated Facility Ow er or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 188 Pdntedfryped NameSignature Month Day Year G hU6 C4 YUA I PALa , EPA Form 8700-22(Rev.3.05) Previous editions are obsolete. DESIG14ATED FITY TO DESTINATION STATE(IF REQUIRED)