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1 <br /> fill <br /> Please pnntortype. <br /> ERI:Clean rth :~~ e <br /> UNIFORM iiAZARDOtl5 1,Ger rata# Number <br /> ber 2.Page 1 w 3.F.me gen y Response i <br /> � 3 <br /> WASTE MANIFEST CF�I39316631O7 1 (877) 577-2669 0. 59 <br /> 5.Generator's NaM,-and Mae=,ng Address Generawes Site Address(if d remnt than m."aa*n_, <br /> Pep BOYS ##710 pep Bovs##710 <br /> (209) 464-6066 845 Dr.M.L.King Jr. Blvd 845 Dr.M. L.King Jr. 31 d <br /> GenemWsPhone: Stockton CR 95206 Stockton, CA `75 <br /> 6-Transporter 3 Company Name <br /> U,&.EPA 10 Number <br /> Clean Earth Specialty Waste Solutions M 0 4 <br /> 7.Transporter 2 Company Name e Ut EPA ID Number <br /> Worldwide Rega—very Sygteps <br /> s.Desgnated warty Name and Site Arg Yuma Yes, LLC €J.S.EPA 1pWinnber <br /> 2730 E. 13th Street <br /> Yuma, AZ 85365 <br /> Fact 's 9286428938 <br /> 3a. 9b.U-6-DoT Desaipaon Choud;ng Proper S1Nppitxd Name,Hated C .K)*-,tW, dtP:CFA"8 bY5 <br /> E, sz <br /> WA and P Group ftr may)) r � 13 Wage Codes <br /> i-Non RCRR hazardous waste, liquid ( Auto Care i € P 33 <br /> o Products), <br /> a 2. <br /> 3. <br /> 4. <br /> t4.5pocial taaxtf rg Ir sft0io rs ars€Aftboro j 7k 1.78411-(State Regulated L i g u i d s) k <br /> t. <br /> 5; <br /> Eal°�� 'l r <br /> 15 GENERATDR'S#OFFERpR'S CERTIFICAMN,t t dem ti t ronlarts of this cGnsignnwnf a e fi Y and ate described above b the <br /> Y Y Y P*W sly png name,aW are ctassAfied,Pa",kaged, <br /> marked arab labeled pts d®d.and are in aI(respects m p DW wrdom bf trarspod according to appkable nlema nal and nah"t governnwW regutat".!f export shipment and!am dle Frim" h€ <br /> Extorter:I cartuy that ft oww is of ft wrcavnmernf wnbfm so ft f$M Gf the alieched EFA ArkrrowWgrnent of Cortsenf. <br /> I cert#y#at ttte wrote minentzabon slatement identdied in 4t,'CFR 26227(a){if I am a large quantrty 8ersarato j#1 am a )l q rity ge mor)is ire. <br /> IIm°`( tosPnMadfryped N Month Day Y r <br /> shy <br /> p ❑hpmt to U.S. Expert P al $: <br /> f b <br /> Transpofw signabire r erpyts 00y): <br /> W 17.Trairspoder Ackt>�nerrt of Receipt of Haien Uj <br /> ® v S.: <br /> Transporfer 1 Pffitadayped Nam Sgnanve Moret Day Year <br /> Darr T041 07 202 <br /> 2 typed Na;ne S mna a Monro Day Year <br /> 18a.DrspePV SIP— T7Pe ❑Residue Partial Refww FUR RoMwori <br /> I <br /> 1 ab.AAitesrcafe Fa*y(or Ganerator) ManPfesi Referee Number <br /> U S EFA iD Number <br /> ua.. FaalibfsPfrarie. <br /> 18c-Signature of Altemahe Fa (or Generator) <br /> 'tonth Day Year <br /> Z <br /> co19.HazWOW WasL-Repa9 MarragemeM MOtcd Cedes(te-,codes fcx hazardous wasle trwtrnent,disposal,and recydrg syse€rs) <br /> © 1' 2 $ 4_ <br /> L <br /> PL.Designated Faatity r or Operatm Cvt6c85on of receipt of hazardous materials Covered by the marifes€except as roedVem 1$8 <br /> PrinledfTyped Name <br /> 5gnatuve Day Year <br /> EPR Form 8700-22(Rev.12-17) Previous editions are obsolete, t3E XIG T D CILI( TO EPA's e4ANITEST SYSTEM <br />