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Please print or type,(Farm designed for use on elite(12-pitch)typewriter.) t=erm Approved.OM8 No.2050.0039 <br /> UNIFORM HAZARDOUS 1.Gencratar ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Humber <br /> WASTE MANIFEST CAD 9 81 S S 3 0 7 1 (800)424-9300 016870121 JJ K <br /> T.Generator's Name and Malling Address Generator's Site Address(ff dilterent than mailing address) <br /> PEP BOYS#0710 is <br /> 20f E ORCHARD STRM <br /> HAMMONPON "' N.1 08037 846 MARTIN LUTHER KING BLVD, <br /> Generators Phone: 209 464-0066 STOCKTON CA 95206 <br /> 6.Transpdrier 1 Company Name U.S.EPA ID Number _ <br /> WORLD OIL ENVIRONMENTAL SERVICES CAD 0 2 8 2 7 7 0 3 6 <br /> 7,Transporter 2 Company Name U,S.EPA ID Number <br /> 8.Designated Fae➢ily Name and SheAddress U.S.EPA ID Number <br /> DEMENNO/KERDOON <br /> 2000 N.ALAMEDA STREET <br /> COMPTON CA 90222 CAT 0 8 0 013 3 5 2 <br /> Faciliiya Phone: (310)537-7100 <br /> ga. 9b.U.S.D6T Description(including proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Focal 12.Unit 13.Waste Codas <br /> HM and PacWg Group(if any)) No, Type Quantity WtNol. <br /> 1 NON-RCRA H=RVOUS WASTE,LIQUID(HYDRAULIC OIL) 343 <br /> DM �� G <br /> m <br /> LU <br /> 3. , <br /> 4. <br /> 14,Special Handling Instructions andAddltlonaf Information <br /> EMERGENCY CONTACT:CHEMTREC 1800.424-9300 WOES TERMINAL:CERES CS w PROFILE#t 901:OIZ2019-01" <br /> HYDRAULIC OIL* wAPPROPRIATE PPE EQUIPMENT <br /> 15. GENERATOR'SIOFFEROR'S C£RTIRCATION:I hereby dedara that the contents of this consignment ate fully and accurately desenbed above by the ptopershipping name,and are classified,packaged, <br /> marked and labeled/placarded,and aro in all respects in proper condition for transport according to applicable International and national govemmental r �tlo- <br /> an <br /> a.If exportshlpmera and I am the Primary <br /> Exporter,Ice"that the contents of this consignment confoml to the terms at rhe attached EPAAcimawfedgment of Consent. <br /> I certify that the waste minimlzat tement Idenfified in 40 CFR 262.27(x)(if I am a farge quantity generator)or(b)(ff I a small quantity g ratot)itoe fle Print yea S na re Month Day Year <br /> 10-1122119 <br /> e-€ 16,Intem lanai Shipme <br /> t- ❑Import in US. ❑Export from U.S. orf of entry/ft <br /> Transpoilersignalura(for exports only): Date leaving U .: <br /> W 17.TranspoderAcknowledgment of Receipt of Materials <br /> Trans pa 1 dntedfryped oma Signature Month Day Year <br /> co <br /> or z3 �s <br /> z T€ansparter2 rintodlTyped am Signature Month Day Year <br /> 16,Discrepancy <br /> 18a.discrepancy Indication SpaceElQuantityI�I <br /> ❑Type ❑Residue ❑Partial Rejection ❑Fell Rejection <br /> Manifest Roferenta Number. <br /> 18b,Alternate Fatuity(or Generator) U.S.EPA ID Number <br /> u <br /> U. Facifty+s Phone: <br /> eLis 18x.StgnalureofAhemateFacility(orGe%ralor) Month Day Year <br /> Q <br /> z <br /> 19.Hazardous Waste Report Management Method Codes(I.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> C <br /> 20,Designated Facility Owner or Operator:Cedification of receipt of hazardous materials covered by the manifest except as noted In Item M <br /> Printedlfyped Name Signature Month Day Year <br /> EPA Farm 8700-22(Rev.3-05) Previous editions are obsolete. Dl;SIGNATED FACILI TO DESTINATION STATE(IF REQUIRED) <br />