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•Ili Mean print'ortype.(Form designed for use on elite(12-pitch)wewrlter,) ,y Form Approved.OMB No.2050-0039 1.Genera ID Number" ' 2.Pagri'Yof- i.ETliergenty Response Phone 4.Manifest Tracking Number JJ K UNIFORM HAZARDOUS _ rN --% .� `'t " WASTE MANIFEST CA L C 0 0 2 5 7 .a 2 7 � 1800)424.9300 �,.y l :;s f :,� �..,.; S.Generators Name and Mailing Address Generators Site Address(d different than mailing address) C?BPPF L i Mri ORS- C•Ji6011- P.O. SOX 2185 t'�4?lt's`i'�.C�. }.:?Z4,)IN YGSEENil i T r_AV E Genera(ors Phone: 20$923-1 148 i11ANTECA CA S533'1 6.Transporter 1 Company Name U.S.EPA ID Number '&ORL€a OIL El''WIFtt)NtViENTAL ZEF!Vif:ES C AD 0 2 8 27 7 00 ra 7.Transporter 2 Company Name U.S.EPA ID Number S.Designated Facility Name and Sjte Address U.S.EPA ID Number ;��I�.i;sdt�lLli i{FRi)L}Cilli 20017 14.ALAMFDASTREE COI:iPTOi~1 ;r:'� 40'22? C A 7 J 80013352 Facility's Phone: >;3si)j537-•11.0(3 93• 9b.U.S.OOT Description(including Proper Shipping Name,Hazard Gass,1D Number, 10,Containers 11.Total 12.Unit S3.Waste Codes HM and Packing Group[f any)) No. Type Quantity WtNol. W410-93, Vdr",STE FLAMMABLE LIQUID. d.O,S•.(GASOUNE, DiesEI., ;: 01 )018 ;43 10 ViIATER'k, S. PCI? ppil r LU LU 2. R wTHIS WASTE STREA)l HAS EEE^!QUALIFIED FOR K Y /1' r-A'' :r 1T 1TT ' 3, DeMENNO/KERDOON D1334 WOHLE)OIL RECYCLING FACILITY IN CC?MPTON,CALIFORN IA. THIS FACILITY HAS THE NECESSARY PERMITS TO F 4. OUR EPA NUMBER IS CAT080013352 t _ c 14.Special Handling Instructions andAdditional Information -M { Cu x ,;i 4' G( /��) d 1C`VOI;3 TPERit-VIN t_: RES;1S INA 1� 198 C FI I. #5c�i _ --FSP -r E-,.-tT 1 1 1 _4'f t' i i`,' 1 w �;E'� '=F=i 1 3S{.Oir1 C:iSOLINI . DIESEL.,WATER * 'IAPPROPRKTE rFE EOUItPME,NT � 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 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,l 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)(rf l am a large quantity generator)or(b)(if I am.a small quantity generator)Is true. Generators/Offerors Printedf.Typedl Name Signature Month Day Year - -r 16.International Shipments ' F ❑Import to U.S. ❑Export tom U.S, 'Port.of_entry'fexit 2 Transporter signature(for exports only): Date leaving U.S.: W 17,TransporterAcknowledgment of Receipt of Materials a Transporter 1 Printed)7yped Name Signature Month Day Year t.-jFY'-� • Transporter 2 Printed/Typed Name Signature Month Day Year t- 18.Discrepancy 18a.Discrepancy Indication Space ❑ quantity ❑Type ❑Residue ❑Partial Rejection ❑Fu II Rejection Manifest Reference Number,. 18b.Akemate Fadlity(or Generator) U.S.EPA ID Number Zi V uQ. Facilitlrs Phone: W - 11 lee.Signature of Altemate Facifty(or Generator) Month Day Year a z US19.Hazardous Waste Report Management Method Codes(i.a.,codes for hazardous waste treatment,disposal,and recycling systems) W 1, 2. 3, 4. (41 5 f 20.Designated Facility Owner or Operator.Car9cation of receipt of hazardous materials covered by the manifest except as noted in Item 18a PrintedlTyped Name f Signature Month Day Year EPA Form 8700-22(Rev.3-05) Previous editions are obsolete.' DESIGNATED FACILITY TO GENERATOR